Fiducia Wealth Management

Not all care has to be paid for privately or funded by the Local Authority, where there is a health need care funding by the NHS may be available.  There are two main forms of NHS funded care: NHS Continuing Healthcare; and Registered Nursing Care Contribution.  Neither are taxable or means tested.

NHS Continuing Healthcare

Continuing Healthcare (CHC) is care arranged and fully funded by the NHS where a ‘primary healthcare need’ is identified.  A two stage assessment process is used to determine eligibility for CHC.  Firstly a checklist assessment is made by a health or care professional and if that indicates sufficient healthcare needs referral is made for a full assessment by a team of health and care professionals.

The assessments will look at a number of factors including the complexity, severity and predictability of the person’s condition; it is not dependent on a specific illness or diagnosis.  Conditions that will be assessed include the following headings:

  • behaviour
  • cognition (understanding)
  • communication
  • psychological/emotional needs
  • mobility
  • nutrition
  • continence
  • skin (wounds/ulcers etc)
  • breathing
  • symptoms controlled through medication
  • altered states of consciousness and
  • other significant needs.

Each heading will be rated priority, severe, high, moderate, low or no needs.  Where at least one priority or two severe needs are assessed eligibility for NHS funded care should be established.  Eligibility may also be established where a number of severe or even moderate needs are present, the decision will depend on the interaction between the needs, their severity and complexity.

A decision as to eligibility should be made within 28 days of it being decided that a full assessment is required. When eligible for NHS Continuing Healthcare (CHC) the next step is for a care package to be arranged.  Care can be provided in a variety of settings such as at home or in a registered care home.  The person receiving care should be involved in the decision making process, however, the cost and value of options will be taken into account.  It is not possible to privately top up NHS funded care and this should be borne in mind when making decisions about the care package.

The needs and support package should be reviewed after three months and then annually thereafter.  If the needs change then the support package may well change as a result.  Eligibility for NHS CHC will cease if needs are re-assessed in the future to be below the required threshold (i.e. if conditions improve) or on long term admission to hospital.  Some state benefits, such as Attendance Allowance and Disability Living Allowance will cease if the recipient becomes eligible for CHC, however, State Pension is not affected.

 Registered Nursing Care Contribution

Registered Nursing Care Contribution (RNCC) is an NHS funded payment to cover the cost of nursing care provided in a nursing home.  Where a resident has been assessed as needing nursing or medical care but are ineligible for NHS Continuing Healthcare, they may qualify for RNCC.  Assessment for RNCC should not be considered until it has been agreed that the resident is not eligible for Continuing Healthcare. Only care provided by a registered nurse is classed as ‘nursing care’ in this context and therefore RNCC payments would not be made to residential homes where nursing care is provided by NHS nurses working in the community; only in nursing homes where registered nurses are directly employed by the home.

RNCC is tax free and non-means tested and can be claimed whether a resident is self-funded or local authority funded.  Payment is made directly to the care home to cover the cost of nursing care provided to the resident.  RNCC is a flat rate of £110.89 per week (2014/15 in England, different rates apply in Scotland, Wales and Northern Ireland) for those assessed on or after 1st October 2007.  Prior to that time a three tier system was used with payments depending on the assessed level of need; those on the low or medium rate as at 1st October 2007 were automatically switched to the new flat rate, however, those receiving the higher rate (£152.61 2014/15) will continue to do so unless their needs are assessed as having reduced to low or medium at review and in which case they would move to the new flat rate.

As RNCC is only available for those in a nursing home, payment would cease if the resident returns home or goes into hospital.  It will also cease if the resident becomes eligible for NHS Continuing Healthcare.

Where residential care is temporary, RNCC can still be claimed, however, if the period is less than 6 weeks a full assessment is not necessary and RNCC can be paid based on information from the care home or GP.

When RNCC has been granted it should be reviewed after 3 months and annually thereafter.

Should you wish to discuss funding your care needs, or those of someone close to you, please do contact us.


Sarah Travers

Financial Planner

Fiducia Wealth Management Limited

February 2015

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