Forced into a care or nursing home and self-funding due to health needs? When to Seek a Second Opinion?

Why are families having to self-fund care or nursing home fees following a hospital discharge when they had no choice to go back home due to their health issues?

Across the UK, many people enter residential or nursing homes following a hospital discharge or as their health deteriorates. Families are often told by the NHS or the Local Authority that the move into care is necessary because of medical conditions, complex health needs or increasing nursing requirements.

However, despite the care being required due to health needs, families are frequently advised that they must pay for care themselves.

This can create confusion, as the NHS provides a funding scheme specifically designed to cover care costs where a person’s primary need is related to health.

When the NHS Should Pay for Care

Under NHS rules, individuals with significant healthcare needs may qualify for NHS Continuing Healthcare (CHC) funding.

If a person meets the eligibility criteria, the NHS becomes responsible for 100% of the cost of their care, regardless of their savings, income or whether they own a property.

This funding can apply whether care is provided:

• In a nursing home

• In a residential care home

• In the person’s own home

However, awareness of NHS Continuing Healthcare remains relatively low among the public, and many families only learn about the funding after they have already started paying care fees.

We are Encouraging Families to Seek a Second Opinion

When someone is told they require care because of ongoing health problems, but are simultaneously told they must pay for that care privately, it is worth asking further questions about funding.

Eligibility for CHC funding is determined through a structured assessment process which looks at the nature, intensity, complexity and unpredictability of a person’s health needs.

Where eligibility is confirmed, the NHS is responsible for covering the full cost of care.

Rising Care Costs Increasing Pressure on Families

Care costs across the UK continue to rise, with nursing home fees in many areas now exceeding £1,500 – £2,000 per week which is in excess of £100,000 per year. 

For families facing long-term care costs, understanding whether NHS Continuing Healthcare funding may apply can make a significant financial difference.

We advise that where care is required primarily due to health needs, families should seek independent advice or a second opinion on funding arrangements to ensure the correct process has been followed.