Alzheimer’s disease – are you eligible for NHS Continuing Healthcare funding?

Download the podcast: NHS Continuing Healthcare funding

As the nation gets older and the strains on social care become greater and greater, the number of people suffering from Alzheimer’s disease and other forms of dementia will only increase. The NHS document that there are more than 850,000 people in the UK with the condition. That is 1 in 14 people over 65 and 1 in 6 affecting those over 80 years old.

The support and care for this condition varies greatly as the condition itself varies from individual to individual. Some will require residential accommodation and effectively 24-hour care, whereas others will rely upon regular care visits in their own home. Whatever the situation, the symptoms can be complex requiring expert care and support from professionals.

Sadly, as the statistics show, dementia is becoming more common meaning more care and support will ultimately be needed and, in some cases, this will mean digging into savings to pay for that care whether it be in a nursing home or with domiciliary care agencies.

NHS Continuing Healthcare funding – are you eligible?

However, one form of funding does exist – namely NHS Continuing Healthcare (CHC) funding whereby if eligible, all associated care needs are paid for by the NHS. As the name implies in the first instance you need to be able to show that someone’s needs are primarily healthcare based. If so, it means care home fees or care agency fees will all be met by the NHS as healthcare is free in the UK at the point of access.

It is however an extremely complicated and jargon-heavy process and one that requires a thorough examination of someone’s needs. Due to the increase in the individuals who sadly develop the disease, we at Moore Barlow we are seeing a rise in people being of the mistaken belief that just because a loved one has a diagnosis of dementia then they will never be eligible for NHS Continuing Healthcare funding.

This is, quite simply, not true.

Families should be reassured that whilst there is no one condition that automatically makes someone eligible for NHS funding, equally there is no medical condition that would automatically rule out someone being eligible either. This is certainly true of dementia and families should not be discouraged from applying just because a diagnosis of dementia has been given.

The symptoms and needs

The entire CHC process is not strictly concerned about what condition or illness someone has, but rather the symptoms and needs they display as a result of that illness. It is those needs that are clinically assessed by nurses and scored according to the National Framework for NHS Continuing Healthcare regulations and the Decision Support Tool document that grades individual needs. For more information about how needs are weighted and the application process, please see our CHC guide.

As such, when assessing an individual, the nurse assessors are looking to ascertain whether that person’s needs go “above and beyond” what social care would be expected to be provide. Are those needs so complex to manage or is sufficient skill or specialist input required? Are the needs that are displayed extremely time consuming or so frequent that again social care would not be able to attend to? Are the person’s needs so unpredictable that caring for them is problematic? Or overall are the needs of a nature that demonstrates a healthcare rather than social care need?

These are the questions that are asked at assessments for CHC and the only questions that families should be thinking about when assisting in that process. Alzheimer’s and other dementias – just because they are now more commonplace – does not mean they are excluded from potential eligibility. It all depends on the symptomology displayed.

How Moore Barlow can help

At Moore Barlow we specialise in CHC applications and appeals and offer a free preliminary assessment on eligibility. Please contact us our expert team for more information.

Download the podcast: NHS Continuing Healthcare funding