If a client has a range of medical problems, for example high blood pressure, diabetes, and high cholesterol, these conditions can interact and require the intervention of medical professionals, in which case NHS continuing healthcare should be considered.
One area which often presents difficulty when assessing whether someone qualifies for NHS continuing healthcare is when a patient has dementia.
While a diagnosis of Alzheimer’s or dementia does not automatically qualify someone for NHS continuing healthcare, if they have been diagnosed with these diseases and the client - or more typically, the client’s family - are looking for a way to fund care the adviser should make sure that it is something that has been explored, and get them to take advice from an Alzheimer’s charity.
Often Alzheimer’s patients exhibit challenging behaviours and resist treatment.
They are more susceptible to pressure sores because they are immobile for long periods. They may be at increased risk of falls. In these cases the funding is more likely to be available.
If the client is already in receipt of the AA, DLA or PIPs, these benefits will cease while they are receiving long term NHS continuing care.
Although the client may be entitled to NHS care, they may still require an annuity, or to release equity to provide “extras”.
NHS continuing healthcare is notoriously difficult to get.
Because it costs the NHS so much, horror stories abound about the obstacles being put in people’s way to put them off claiming.
Nevertheless, advisers should be aware that people with complex health needs probably should be claiming from the NHS and consequently their additional financial needs will be greatly reduced.
NHS funded nursing care contribution
If a client is unable to get NHS continuing healthcare, but still has nursing needs, they may be entitled to the NHS Nursing Care Contribution.
Unlike NHS continuing healthcare, the nursing contribution is only payable to someone in a care home where they are receiving care from a registered nurse or doctor.
Like NHS continuing healthcare, the nursing care contribution is tax free and non means tested so will reduce the amount they pay in fees.
Typically the nursing care element in a care home does not cover the whole of the fees. The “residential” element of the fees will still be payable by the resident.
However, the contribution will significantly reduce the fees payable and this should be considered when discussing the client’s financial needs.
The current rate of contribution in England is £158.16. Rates are different in Scotland, Wales and Northern Ireland and there was a higher rate before 2007.