The importance of NHS Continuing Healthcare for Financial Advisers

The FTAdviser reports this week on the risk of litigation if a financial adviser has failed to consider all of the possible options for funding an individual’s care fees, including NHS Continuing Healthcare.

Care fees can be expensive, particularly where an individual requires more complex interventions, or an intense level of support. Where they have assets above the threshold to qualify for a contribution from the local authority and are self-funding, they, or their families, may turn to a financial adviser for advice on making their money last.

NHS Continuing Healthcare is a complete package of ongoing care arranged and funded by the NHS for individuals found to have significant, ongoing healthcare needs as a result of an accident, disability or illness. Unlike local authority funding, NHS Continuing Healthcare is not means tested. For those who are eligible, it means that their care fees will be met in full by the NHS. If they are living in a care home, the NHS will make a contract with the provider to pay the fees in full, including all accommodation and care. Where the individual is receiving care at home, the NHS will fund an appropriate package of support designed to meet their health and personal care needs.

Not everyone will qualify for this type of funding and there is a robust assessment process that must be completed. Eligibility depends on whether or not it can be shown that the individual has a primary health need, i.e that the main aspects of the care they require are primarily to address health needs and/or prevent deterioration to their health.

The primary health need test is set out in a National Framework which governs the principles and processes of NHS Continuing Healthcare and provides guidance to support the staff who are involved in the assessment process. The test looks at whether the nursing or health services required by the individual are more than incidental or ancillary to the provision of accommodation and whether the services provided go beyond that which a local authority would usually be expected to provide.

Sadly, there are still a number of misconceptions about NHS Continuing Healthcare around and individuals are often told that they will not qualify for this type of funding without a full assessment of their needs taking place. This may be because of the previous experience of well-meaning carers, or hospital staff, who have developed their views based on their own limited experiences rather than on a detailed knowledge of the Framework.

In addition, there are many individuals who are not awarded NHS Continuing Care following assessment who should be entitled to full funding.

At Moore Blatch we specialise in assisting individuals and their families with the assessment process to ensure that the assessment is robust and takes into account all of that person’s care and support needs. Alternatively, if the NHS has decided not to fund an individual’s care, we can also advise on the prospects of making a successful appeal or challenge, supporting them and their families throughout the whole process.

NHS continuing Healthcare is not guaranteed for life and individuals who are eligible will be reviewed annually to ensure that their care needs continue to be met appropriately.

We work closely with advisers to consider the merits of NHS Continuing Healthcare funding both now and in the future.

Please get in touch if you would like to know more about our service, including how we can offer your clients a free, no obligation initial screening assessment for NHS Continuing Healthcare.