49. What parts of my care will be free?
In general, all health services (apart from dentistry and opticians’ services) are free. In contrast, there is a charge for most social care services, depending on your ability to pay.
If you have significant or complex health needs, you may be eligible for NHS Continuing Healthcare (CHC) funding.
This is the name given to a package of care which is arranged and funded solely by the NHS for individuals outside of hospital who have ongoing healthcare needs. You can receive Continuing Healthcare in any setting, including your own home or a care home.
NHS Continuing Healthcare is free, unlike help from social services for which a financial charge may be made depending on your income and savings.
If you are found to be eligible for NHS Continuing Healthcare in your own home, this means that the NHS will pay for healthcare (e.g. services from a community nurse or specialist therapist) and personal care (e.g. help with bathing, dressing and laundry). In a care home, the NHS also pays for your care home fees, including board and accommodation.
Anyone assessed as having a high level of health care needs may receive NHS Continuing Healthcare. It is not dependent on a particular disease, diagnosis or condition, nor on who provides the care or where that care is provided. Once eligible for NHS Continuing Healthcare, your care will be funded by the NHS but this is subject to review, and should your care needs change the funding arrangements may also change.
If you are not eligible for NHS Continuing Healthcare, the local authority will discuss with you whether you may be eligible for support from them. If you are not eligible for NHS Continuing Healthcare but still have health care needs, then the NHS may still pay for part of the package of support. This is sometimes known as a ‘joint package’ of care. One way in which this is provided is through NHS-funded nursing care.
With ‘joint packages’ you may be asked to contribute financially towards the social care part of the ‘package’, depending upon your income and savings. There is no charge for the NHS part of a joint package of care.
Whether or not you are eligible for NHS Continuing Healthcare, you are still able to make use of all of the other services from the NHS in your area in the same way as any other NHS patient.
You should receive NHS-funded nursing care if:
• you are resident within a care home that is registered to provide nursing care, and
• you do not qualify for NHS Continuing Healthcare but have been assessed as requiring the services of a registered nurse.
Most individuals will not need to have a separate assessment for NHS-funded nursing care if they have already been considered for NHS Continuing Healthcare as this process will give sufficient information to judge the need for NHS-funded nursing care.