A FOUNDING principle of the NHS is that medical care should be provided free of charge at the point of need.

This expectation can cause confusion when it comes to long-term care. If you have needs that are classed as ‘social’, care is provided by the local authority and is subject to a means test.

But if your needs arise from a ‘Primary Health Need’ then support – including bed and board – is provided by the NHS and your personal income/wealth is not relevant.

You might think support to cope with a diagnosed illness such as Alzheimer’s or Parkinson’s is automatically a health need but, sadly, this is not the case.

To qualify for Continuing Health Care you must go through an assessment to determine whether your particular needs qualify for NHS funding.

The process is summarised here with some of our ‘top tips’.

Somerset County Gazette:

How the funding verdict is reached

The process starts with a brief paper-based assessment. This filters out weak applications.

If the short process identifies serious needs then a full assessment is completed using a Decision Support Tool.

A recommendation is then made to the Clinical Commissioning Group (CCG) to either provide or refuse funding.

The CCG does not have to accept the recommendation but it should let you know the outcome and provide reasons for its decision.

If you are not awarded funding you can appeal. If funding is awarded it is not guaranteed to last forever – even if you have a degenerative condition.

For more details, click here.

If you have a medical condition that has given rise to care needs, ask for an assessment to be performed. They do not cost anything and in the case of degenerative illnesses they will let you understand how close you are to NHS funding.

Top tips

  • If you are discharged from hospital with on-going care needs an assessment should be performed automatically. Make sure you get a copy and address any inaccuracies or missing information.
  • If you decide to request an assessment you can seek it via your GP, Somerset Adult Social Care or Somerset Clinical Commissioning Group. Why not try all three?
  • When you request an assessment make it in writing and keep a copy. If funding is awarded you should ask for it to be backdated at least to the date of that request.
  • If you have urgent needs make sure you ask for the Fast Track Tool to be used. This should result in a decision being made in days/weeks rather than months.
  • Be persistent. Do not be shy about asking to be involved or for explanations of terms used and/or conclusions reached.
  • If you feel overwhelmed by the process or if you feel you are not being treated fairly – rare, but it does happen – seek advice.