Free NHS Care & Nursing & Social Care Contributions

Introduction

You may be entitled to free NHS care if your “primary need” is for health care or if you end up being sectioned under the Mental Health Act.

General Principles of NHS Care

If you receive nursing care and if your primary requirement is a continuing health care need, or if you are sectioned under the Mental Health Act, then your care will be provided and funded in full by the NHS local Primary Care Trust.  This care should be provided irrespective of what assets you hold and without seeking payment from you for the care you receive.

NHS Assessment

It is crucial you arrange an assessment for NHS continuing care and compare your “Care Plan” with the eligibility criteria for NHS funding.  The criteria for assessment is different in certain areas of the UK, as each Primary Care Trust has its own interpretation of the basic national guidelines for eligibility criteria. We can help you with the assessment process. Please call us for a free initial telephone chat.

The Couglan Case

The availability of free NHS care has been the subject of court litigation over the years.  In the case of Couglan in 1999, the court decided that patients whose primary needs were nursing care were the responsibility of the NHS, and therefore the care must be provided free of charge.  The Local Authority was only responsible for nursing care that was incidental to the main provision of accommodation.  This principle was confirmed in a further important case of Grogan in 2006.

Challenging NHS Decisions

If you believe that you are entitled to free NHS care, but the Primary Care Trust has decided otherwise, then you can challenge the decision.  However, you need to be fully prepared and ensure that you provide as much information and evidence as possible in support of your arguments.  Make sure that you obtain the full details of the Primary Care Trust decision and you obtain all of your relevant medical records.  It is possible to claim a refund on care fees after a loved one has died if you believe a decision that was made when they were alive was incorrect. We can help you with the assessment process. Please call us for a free initial telephone chat.

Summary

Arrange a free NHS assessment to see if you are entitled to free NHS Care.

Obtain copies of the Care Plan and compare with the eligibility criteria for NHS funding.

Challenge the decision – If the decision is that you are not entitled to free NHS care.

Re-apply for funding – If there is any deterioration in your condition.

Introduction

If you receive a mixture of nursing and social care, then you can claim a contribution towards the care fees.

Mix of Care

If you require a mixture of nursing and social care in a nursing home, a registered nurse will assess the level of care needed.  If the nursing care is incidental to the accommodation required and you are in the nursing home primarily as part of a social care package, you may be charged care fees by the Local Authority.  You may however, be able to claim a contribution towards the care fees which will depend upon the level of nursing and social care needed.

Non-Residential Care At Home Services

If you are receiving care at home the Local Authority has discretionary powers and may charge only a reasonable amount for providing those services.

Respite Nursing Care

If you stay in a nursing home for a short respite period then it is also possible to claim a NHS nursing care contribution.

Health Deterioration Claims

If you are unable to claim for NHS contributions at the moment, this can change in the future.  If your circumstances alter, then it may be possible for you to lodge a new application for free NHS care to cover any changes that occur.

Summary

Arrange a free assessment to see if you are entitled to a contribution towards the care costs.

Obtain copies of the Care Plan and compare with the eligibility criteria for NHS funding.

Challenge the decision – If the NHS decides that you are not entitled to a contribution towards NHS care.

Re-apply for funding – If there is any deterioration in your condition.