Changes to NHS Continuing HealthCare and Funded Nursing Care
Brendan Paddy, Age Concern England, 020 8765 7350
26.09.07
Introduction
NHS Continuing Healthcare - often called ‘fully funded NHS care’ or sometimes ‘continuing care’- means that a Primary Care Trust (PCT) pays all the costs of someone’s care. This care is often provided in a nursing home but can also happen in the person’s own home or a residential care home. The decision to provide fully funded NHS care follows a medical assessment which has shown that a person has a
‘primary health need’ which in effect means they need a very high level of care because of an ongoing medical condition. The latest figures produced by the Department of Health in July 2007 show that 31,000 people get their care fully funded in this way. NHS Continuing Healthcare means that a Primary Care Trust pays the full costs of the nursing or care home, including non-medical costs. If the person lives at home the NHS pays for all the health and personal care they need.
If a person in a nursing home does not qualify for fully funded NHS care, they get a contribution paid by the NHS towards the cost of the care they receive in the home. This is known as the Registered Nurse Care Contribution (RNCC). Until 1 October 2007 this payment was made at the rate of £40, £87 or £139 depending on whether the person’s registered nursing needs were assessed as being low, medium or
high.
Changes coming into affect on 1 October
The most significant change from 1 October 2007 is that the people receiving the lower or middle band (RNCC) will have the rate increased to £101 pounds per week. The RNCC is paid directly to care homes so this should be good news for people who fund their own care, as the amount they have to pay to the home should drop by either £61 or £14. We estimate that there are about 30-40,000 people who are
funding their own care in a nursing home and who are currently on the middle or lower band. The change is not likely to make any difference to those funded by the local authority.
Those in the highest RNCC band (£139) will stay on this level until they are reassessed- at that point they might:
move onto fully funded NHS care if their needs have increased or been underestimated - in which case full funding should be backdated to 1 October,
stay on the old higher rate if their care needs remain above the description for the old middle rate,
move to the new single band (ie £101) RNCC if their care needs are found to have decreased or been overestimated,
receive no further payment if they no longer have nursing care needs.
Potential issues arising for vulnerable older people
Incorrect or arbitrary assessments of those currently in the highest RNCC band
Currently between 15,000-20,000 people are in the highest RNCC band. It is estimated that around 5,500 of these will be deemed eligible for NHS Continuing Healthcare when they are reassessed. There remains a right of appeal against these assessments and patients or their carers can now ask to see much more detail of the assessment that lead to the decision. Age Concern is worried however that PCTs and
other NHS bodies may assess those with a complex combination of low, medium and high care needs in a way that wrongly deprives them of fully funded NHS care.
Care home charges
There have been reports which suggest that some care homes are intending to increase their charges to residents receiving nursing care on 1 October 2007. Since September 2006 homes have been required to increase the transparency of their charges in order to combat the common practice of varying charges depending on how a resident’s place is funded. Residents and their families should use this
information to challenge any arbitrary increase in charges on 1 October. Otherwise, those receiving nursing care may not see the benefit of the NHS contribution being increased.
Age Concern England’s role
Age Concern England will be looking closely at how PCTs implement these changes and monitoring their impact. We would be particularly interested to hear from anyone who feels that their needs have been wrongly assessed or who believes that their care home charges have been arbitrarily increased to absorb the increase in the NHS contribution.
Age Concerns around the country may be able to offer advice or could refer people to those who can. Our information service will be updating its fact sheets and can offer telephone advice on 0800 00 99 66.
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