FINANCIAL HELP FOR SPECIALIST NEEDS

For those individuals who have an acute or specialist care need, additional financial help may be available:

Continuing Care Benefit

Under current legislation, individuals who have an acute nursing requirement because their primary care need is healthcare are entitled to continuing care benefit. This is provided by the NHS and funds all costs associated with the care need. Entitlement to continuing care benefit is dependent on the individual meeting the health authority’s eligibility criteria. Those individuals who have a severe nursing requirement should establish if they have an eligibility to continuing care benefit by contacting their local Health Authority/PCT and asking for an assessment under the National Framework for NHS Continuing Healthcare & NHS Funded Nursing Care.

Registered Nursing Care Contribution

Under the terms of "free nursing care" the Government states that the NHS will pay for "any services provided by a registered nurse involving the provision of care, or the planning, supervision or delegation of the provision of care, other than services which do not need to be provided by a registered nurse."

In England:

If you were living in a care home on 1st October 2007 , your nursing needs will have been in the low, medium or high band, the rates for these bands being £40 - £139 per week. From 1st April 2008 (announced by the Department of Health on 13th August 2008) however,

New residents and residents who were on the Low or Medium bands , now receive the flat rate of £103.80 per week regardless of the level of nursing care required. The nursing needs will be identified as part of your comprehensive needs assessment and included in your care plan. 
Respite care will also attract this rate so long as the stay is not for less than 6 weeks.

Residents who were on the High Band will recieve £142.80 unless on reassessment:

• you are found to be eligible for NHS continuing healthcare (the full cost of your care will then be the PCT's responsibility);
• your nursing needs have diminished to the extent that if the old guidance relating to nursing bands were applied, you would only be eligible for either the low or medium bands (the PCT will then pay the single rate of £103.80 from 14 days following notification of the outcome of the reassessment);
• you no longer have nursing care needs.

For many, the concern is that the level of funding provided through this system may not directly meet an individual’s nursing costs and that consequently a shortfall may arise. Claims should be made to the NHS co-ordinator via the care home and payments awarded will be made directly from the National Health Service to the care provider.

If you disagree with the decision made following reassessment you can ask the Primary Care Trust for a review of the decision and if necessary, an independent review.

Any complaints regarding the nursing care paid for or provided by the NHS can be made using the NHS complaints procedure via the care home, the Primary Care Trust or Health Authority.

	For nursing care information in other parts of the country
	State Funding Bulletin For a copy of the CareAware information bulletin
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