Continuing Healthcare funding repayment delays continue in Wales

Published: 07/08/2015

The Chair of the Public Accounts Committee in Wales has called for an update from the Welsh government on its efforts to address the long-standing backlog of claims for NHS Continuing Healthcare.

NHS Continuing Healthcare delivers funding for people with a primary health need. Following a successful application and assessment all care needs are paid for by the NHS, and for those requiring nursing care costs of up to £40,000 are covered by the fund. Continuing Healthcare isn’t means tested. Local health boards rule on claims and deliver the funding.

Whilst more than £50 million has been paid to Welsh claimants who’ve been able to successfully reclaim care home fees a backlog of appeals remains. There are still cases going back a number of years and indeed some claimants have died whilst their case is being considered.

In 2014 the Welsh government revised the national framework for ruling on NHS Continuing Healthcare decision-making and increased staff training. More recently the government has increased staff numbers and continued to invest in additional training in an effort to address this problem.

Lee Baker, Head of Care Home Fees comments on this situation:

“Awareness of NHS Continuing Healthcare funding remains low with many people failing to reclaim care costs because they didn’t know about this funding or because they didn’t think they were eligible.

“For the avoidance of doubt, anyone who requires residential care because of a primary health need should have that nursing care funded by the Clinical Commissioning Group (CCG). Health conditions which constitute a primary health need are: dementia, Alzheimer’s, suffering a stroke or having a history of heart attacks. This funding is not means tested.

“Whilst the Welsh government are taking steps in the right direction I feel they, and the government across the UK, still have some way to go in addressing the public information needs around Continuing Healthcare funding.”

Content correct at time of publication