NHS Continuing Health care Funding
Why solicitors specialise in NHS care home funding
If you need ongoing care in relation to complex physical or mental health needs, your care fees may be paid by the NHS. This is known as NHS continuing healthcare.
Unfortunately, Primary Care Trusts often make arbitrary NHS care funding decisions. As a result, you may not receive NHS care funding in a residential care home, nursing home or in your own home, even if you are eligible.
Cate Searle, one of the country’s leading NHS continuing health care funding experts, has successfully challenged many NHS care funding decisions over the last 10 years. In one case she reclaimed nursing home fees of £90,000 and she regularly saves families up to £1,000 in weekly care home funding fees. Read our case studies.
For NHS continuing healthcare funding advice see Cate Searle’s Accessing Continuing Care Funding Factsheet, watch our NHS funding for care video below or call Cate on 01273 609911..
Who is eligible for NHS continuing healthcare?
If you demonstrate a primary health need, the NHS must pay for your care in full, regardless of your personal wealth. To qualify, you must demonstrate your needs are:
- Complex, intense or unpredictable and
- Not incidental or ancillary to the accommodation your local authority is under a duty to provide or
- Not of a nature typically provided for by a social services department.
Challenging NHS continuing healthcare decisions – our fixed-fee assessment
There are many reasons why NHS care funding decisions may be wrong. If you have been denied funding and are paying for your own care, you may be able to reclaim your nursing home fees through a legal challenge.
In the first instance we will ask you to complete a form giving us an overview of your challenge. Using this information, we will then give you a fee, based on the complexity of your case, to produce our initial advice. You will not have incurred any fees at this stage. If you want us to produce this initial advice, you can then be sure of the costs involved. And you will benefit from a discounted rate of £150 an hour (plus VAT).
If the case is straightforward – for example advising on an NHS Continuing Healthcare Checklist or before a decision is made – an hour of our time may be sufficient. In one client’s case, a one-hour consultation and an expert letter alone were enough for them to reclaim £60,000 in nursing home fees.
Normally, however, three hours is adequate for us to provide an initial written opinion and, if appropriate, a letter to the NHS identifying the basis for appeal – a cost ceiling of £450 plus VAT.
If your case cannot be resolved at this stage we can:
- Prepare detailed representations
- Manage the entire challenge process
If you are retrospectively claiming nursing home fees, we can often manage this on a no-win no-fee basis. Where nursing care fees are still being incurred, we will give you a comprehensive assessment of your case, the prospects of success and the likely cost.
If you would like to know more about the grounds for challenging a NHS continuing healthcare decision, see Cate Searle’s Challenging Continuing Care Funding Decisions Factsheet.
Challenging a funding decision retrospectively
If you believe a relative who has now died was wrongly paying for care, you may be able to bring a retrospective review for NHS funding. Our NHS continuing healthcare team has significant experience bringing successful retrospective cases, recovering between £40,000 and £130,000 for families (see our care home funding case studies). We are always happy to consider funding this type of case under a no-win, no-fee agreement following an initial assessment of the facts and merits. This funding option might allow you to feel secure about taking action against the NHS without incurring high legal costs.
Want to talk to us for NHS care funding advice?
If you would like to talk to us about NHS care home funding email Cate Searle or call your local martin searle solicitors’ office on 01273 609911 (Brighton) or 0845 189 0152 (Croydon).
