In this article, we will discuss what NHS-funded nursing care is, who is eligible to receive it and how to claim it.
NHS-Funded Nursing Care (FNC) is funding provided by the NHS to cover the cost of nursing or medical care for those that live in a care home or a nursing home. The care is administered by a registered nurse and is also known as Registered Nursing Care Contribution.
FNC differs in each of the constituent countries of the UK: in England and Wales it is funded by the NHS, in Northern Ireland it is funded by the Health and Social Care (HSC) Trusts, and in Scotland there is an equivalent form of support that includes free personal care and covers the costs of nursing care payments.
The NHS pays a flat rate for the nursing element of care that is provided by a registered nurse. This might include planning your care or carrying out specific tasks. However, it doesn’t cover the other care home costs, such as food and accommodation.
Those with long-term complex health needs may qualify for free social care, which is also funded by the NHS and is known as NHS Continuing Healthcare.
If not hospitalised and if the individual is deemed to have a ‘primary health need’, then NHS Continuing Healthcare may be given to the individual. A breakdown of what may qualify as a primary health need can be seen here.
NHS Continuing Healthcare funding will cover 100% of the cost of receiving full-time care, including social care and accommodation. The difference between this and FNC is that FNC only covers the nursing care, rather than all of your care home fees.
If the individual doesn’t qualify for NHS Continuing Healthcare, they may still be eligible for FNC.
FNC can be provided to an individual if:
FNC is not means tested, this means that income and savings aren’t factored into the decision and you can be eligible regardless of whether you are paying for your care yourself or if your local authority is paying.
A multi-disciplinary team of health and social care professionals will assess the individual in the usual place of residence of the individual, and determine whether they qualify for NHS Continuing Healthcare or for FNC.
Claiming FNC will not affect your entitlement to any other benefits in England, Wales and Northern Ireland. However, in Scotland, if you are receiving a personal care allowance, then claiming FNC will mean you are ineligible for Attendance Allowance, Personal Independence Payment and the care part of Disability Living Allowance after the first 4 weeks.
If your health deteriorates, then you will be assessed for eligibility for NHS Continuing Healthcare. This assessment is usually begun by the professionals caring for you. If you don’t meet the criteria for NHS Continuing Healthcare, you may be eligible for FNC.
The initial checklist assessment can be completed by a nurse, doctor, a social worker or another healthcare professional. You should be made aware that you are being assessed as your consent is required.
The initial checklist assessment will determine whether you are potentially eligible for NHS Continuing Healthcare of FNC; if you are, you will require referral for a full assessment of eligibility.
The full assessment of eligibility will be carried out by at least two healthcare professionals from different healthcare professions, and will consider your needs for things such as breathing, nutrition, continence and skin. The full list can be seen here.
As the assessment for NHS Continuing Healthcare looks at your care needs, usually you will not then need a separate assessment for FNC, as this will be reviewed as part of the NHS Continuing Healthcare assessment.
In a nursing home you should have your nursing needs reviewed annually and eligibility for NHS Continuing Healthcare and FNC will be considered during this. If you qualify, the NHS will arrange and fund the required care; this will be done by a Health and Social Care Trust in Northern Ireland.
A care and support plan is for anyone who either cares for someone else or needs care themself. The plan will detail what support you need, how much of the support will be given and how much money your council will spend on the care.
Depending on your situation, there are different options which might be considered most suitable, such as either receiving support in your own home or in a care home. The plan allows you to have as much control over your life as possible, to understand your health status and the care you require to stay as independent as possible.
The amount you can get per week varies and depends on your location.
For 2021-22 the amounts are:
*In England you might qualify for a higher rate of £258.08 a week if you qualified for FNC before 1 October 2007 and still qualify now in 2021-22.
The amount you receive should be paid weekly to your nursing home. If you pay for your own social care, instead the amount you should be deducted from your bill.
Your eligibility for FNC can change in a few different scenarios:
If you qualify, your needs will be reviewed within the first three months of receiving your support package. After that, it will be reviewed at least once a year, where they check whether your existing support adequately covers your assessed needs.
A personal health budget is an amount of money used to support an individual's health and wellbeing. The budget will be discussed and agreed by you or your representative and your local NHS staff.
The budget allows you to manage healthcare expenses, e.g. treatments and equipment, in the best way for you. It will set out what your health and wellbeing needs are, what you wish to achieve regarding your health, how much money is in the budget and where the money will go.
Those receiving NHS Continuing Healthcare have the right to have a personal health budget. If you don’t have an automatic right to one but would like one, you can speak to your local Clinical Commissioning Group (CCG) to potentially arrange one.
You can get independent advice, casework and advocacy from a company called Beacon. Beacon helps individuals and families who are being assessed for NHS Continuing Healthcare, or who are appealing against the assessment.
It is a service independent of the NHS and they can challenge eligibility decisions where possible to ensure you get the treatment you require. Beacon can ensure that there is smoother communication between the NHS and the public, and help with terminology and understanding the assessment process.
We hope this answered any questions you had about NHS Funded Nursing Care!