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Overview of the new proposed cap on care costs: who can benefit

by Ridley & Hall in James Urquhart-Burton, NHS Continuing Healthcare posted December 16, 2021.
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The Government’s recent Health and Care Bill is rightly receiving a lot of media attention at the moment, given the likelihood that an £86,000 lifetime cap on care costs could be introduced.

This has finally come against a backdrop of overwhelming support for our NHS – local authorities and social care have long felt financially neglected and overlooked.

However, one aspect of providing financial support to the social care industry which often overlooked, is the process of ensuring that those who should be entitled to NHS Continuing Healthcare Funding actually receive it.

NHS Continuing Healthcare Funding is the name given to a lesser-known package of care, which is funded by Clinical Commissioning Groups (CCGs). Think about CCGs as similar to local authorities / councils, but instead of being responsible for social care in your area, they are instead responsible for healthcare.

CCGs must fund 100% of your care, irrespective of your financial means, if you have been assessed as having a “Primary Health Need”.

Whilst everyone knows that funding for care is available on a means tested basis from the local authority, the vast majority of people have likely never heard of NHS Continuing Healthcare Funding. Those who have heard of it will probably tell you that you “have to be on death’s door to get it”. This is simply not true.

What is true, however, is that there isn’t a straightforward tick-box assessment and there is no single example of what constitutes a Primary Health Need. Further, because assessors have to exercise their professional judgement based on their understanding of your needs, there is huge scope for variation and inconsistency in eligibility decision making.

As a general rule, if you would describe your needs, or those of a loved one, as intense, complex or unpredictable, then you should be taking NHS Continuing Healthcare Funding seriously.

The failure of professionals to refer people for an assessment, the untrue myths about who should qualify, poor decision making, and a lack of awareness all contribute to local authorities providing social care funding to individuals whose care arguably should be funded instead by the NHS.

If you have queries or are having difficulty accessing NHS Continuing Healthcare Funding, our specialist solicitor, James Urquhart-Burton has 10 years of experience in securing NHS Continuing Healthcare Funding for individuals and their families. Make a free initial appointment with James at Ridley & Hall Solicitors on 0800 860 62 65.


James Urquhart Burton

James Urquhart Burton – Partner & Solicitor






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