It is a little known fact that people whose primary need is for health care, arising from physical illness or injury, or mental health difficulties due to Alzheimer’s Disease or Dementia, may be eligible to have their care fees paid by the NHS.
It is acknowledged by charities such as Age UK and the Alzheimer’s Society that “tens of thousands of people who might qualify are not applying”. The Alzheimer’s Society stated in May 2014 that around 59,000 individuals were receiving Continuing Healthcare, but they believed that many more could be eligible. The charity states that the chance of success depends greatly on where you live, and whilst there is a National Framework for Continuing Healthcare, it remains a postcode lottery as to how individual areas interpret and apply the eligibility criteria.
Many individuals are funding their own fees (average £25,000 per year), but should be eligible for Continuing Healthcare funding by the NHS.
Are your life savings or your family home at risk?
If you are having to pay your care fees un-necessarily, there are far reaching and upsetting consequences for both you and your family.
- Life savings can be wiped out
- The family home may have to be sold to fund care
- Children are left without their rightful inheritance
It is estimated that there are around 350,000 people in long term care in the UK, with more than half paying their own care fees.
How can this happen?
As different health authorities throughout the UK interpret the eligibility criteria for Continuing Healthcare funding in different ways, some refer to this as the “postcode lottery”. This may affect whether you will be assessed correctly or left to pay the costs yourself. This is blatantly unfair and leads to many inaccurate and clinically unsound decisions as to a person’s eligibility for NHS funding.
We could get your money back
Legal precedents have been set, together with a formal appeals process, to enable families to challenge the decision of a Continuing Healthcare assessment. As a result, if you or a relative have been paying for your own, or a relative’s, care fees in the past (or on an ongoing basis), we may be able to help you recover some or all of those fees.
This means that you could recover thousands of pounds in wrongly paid care fees, and more importantly, change the way that care is funded in the future. We can even seek to recover care costs on your behalf which have been paid for a family member who has since passed away.
In 2012 the Department of Health announced a cut off date for requesting reviews of eligibility for NHS funding, All cases involving periods of care between 1st April 2004 and 31st September 2012 must have been registered with the responsible Primary Care Trust (now known as Clinical Commissioning Group), by no later than 30th September 2012. If your claim was not registered by that date, the NHS would not be obliged to review the case.
A further deadline of 31st March 2013 applied to periods of care from 1st April 2011 to 31st March 2012.
Cases registered by these two deadlines are still ongoing and many are still awaiting review by the NHS. These long delays have been due to the many thousands of cases registered with the NHS by each of the two deadlines.
For periods of care from 1st April 2012 onwards, there is currently no deadline to request a review of any unassessed periods of care, although an announcement is expected by NHS England during 2017. We are monitoring the position and will update our website if and when any further deadline is announced.