Post No19…Explaining NHS Continuing Healthcare (CHC) Funding, and how it affects a care placement.

Introduction

When seeking a care placement, many people come across the phrases CHC, continuing healthcare, FNC etc, and other forms of jargon that are often left unexplained. This post therefore breaks down what NHS Continuing Healthcare (CHC) funding is, how it is different from Funded Nursing Care (FNC) and how it can impact a person’s care placement.

So, what is NHS Continuing Healthcare (CHC) Funding?

In short, CHC funding is full funding from the government paid via the NHS, for those with complex care needs that can be cared for outside of a hospital setting, normally in a nursing home. It is important to note that CHC funding is unlikely to be available to anyone who is outside of needing nursing care or complex dementia care; a person who is still independent would not qualify for this type of funding.

CHC funding is not a loan, and therefore it does not need to be repaid by the person or by their family. It will often pay for a persons care for the rest of their life, but in some cases, it can be reviewed and sometimes removed if the person’s health needs improve over time.

How does CHC funding differ from Funded Nursing Care (FNC)?

Funded Nursing Care (FNC) is also a health-related benefit that is available via the NHS. FNC is designed to cover the additional costs of the nursing care being provided by a nursing home. For example, if a person is living residentially but their care needs change, the home will put in a claim for FNC to cover the additional costs.

FNC is currently paid at £209.19 per week; which is considerably less than the full funding agreement when a person is funded by CHC. However, FNC is much ‘easier’ to claim than CHC, and with less monies in the system now than previous years, it is becoming even harder to obtain CHC.

How do I apply for CHC?

A CHC application comes in two parts. The initial assessment, which can be completed by a nurse, a doctor, another healthcare professional, or a social worker, can be submitted to see if the applicants care needs warrant a full assessment, which makes up the second part. By going to the full assessment there is no guarantee that the funding will be paid out, but it enables anyone to have their case considered.

How does CHC affect a care placement in a nursing home?

This is an interesting point, because although CHC funding (when agreed) is full funding, there is an element of choice restriction. For example, if two care homes have availability, and both agree they can meet the persons care needs but charge different rates, then the CHC bed brokers are likely to opt for the lesser expensive home. Of course, this is not always the case, but with budgets extremely tight, cost can easily become a main driver for finding care placements.

It is worth me saying that CHC teams work extremely hard to try and find the right placement for the person, taking all factors into account, its just they are restrained by very tight budgets outside of their control. However, in some cases, if compelling enough, they will agree to fund at a higher rate if it's in the residents best interest.

Can I ‘top up’ a CHC placement?

As part of the CHC funding process, they must cover the entire cost of a person’s care, which means families are not able to pay any contribution or top ups. This means that a family, who say are willing to contribute to secure a place at a more expensive home, are not able to do so. In these cases, it is between the home and CHC to negotiate an outcome. Historically this was not always the case, and indeed any placements covered by a local authority can be topped up, but not CHC placements.

What is Fast Track CHC Funding?

Fast track CHC funding was used by hospitals as a method of discharging patients quickly into the community to help prevent bed blocking. However, post Covid, this is now mainly being done via the D2A pathway, although CHC are still sometimes involved in the placement.

It is worth noting that a person can apply for fast track CHC funding if they are either at home or in a nursing home, but this is normally because the person requires end of life care. More information about this is available on the NHS’s website.

Conclusion

Both continuing Healthcare (CHC) funding and Funded Nursing Care (FNC) are benefits that are non means tested, and do not need to be repaid. They are assessed on a clinical basis only, for those who need complex care (CHC), or simply need nursing care (FNC). If you are offered CHC funding but feel a little restricted by choice, think hard on it before deciding as it is not something to cast away lightly.

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