Do the NHS Pay for Care at Home? Understanding Your Options

Do the NHS Pay for Care at Home? Understanding Your Options

 In Funding Advice, Home Care

Quick Answer: Yes, but only in specific circumstances. The NHS will pay for care at home through NHS Continuing Healthcare if you have significant, complex health needs. Most people needing home care won’t qualify—only around 15% of applicants are successful. If you don’t qualify, you’ll need to fund care through local authority support (means-tested), self-funding, or benefits like Attendance Allowance.

When Will the NHS Pay for Care at Home?

The NHS can fund home care in two main ways:

1. NHS Continuing Healthcare (CHC)

This is the main route to full NHS funding for care at home. If you qualify, the NHS pays for:

  • All care costs (personal care, nursing care, equipment)
  • Care workers’ fees
  • Care coordination and management
  • Necessary equipment and adaptations

The catch: You need to have a “primary health need”—meaning your main reason for needing care is health-related, not just help with daily living.

2. NHS-Funded Nursing Care (FNC)

If you need nursing care but don’t qualify for full CHC, the NHS makes a weekly contribution towards nursing care costs. Currently:

  • Standard rate: Around £209.19 per week (2024/25 rates)
  • This only covers the nursing element of care
  • You still pay for personal care, accommodation, and living costs

This is much less common for home care and typically applies to care homes with registered nurses.

What Is NHS Continuing Healthcare?

NHS Continuing Healthcare is a package of care that’s fully funded by the NHS for people with significant, ongoing healthcare needs. Think of it as the NHS recognising that your care needs are primarily medical rather than social.

Who Qualifies?

Qualifying depends on having complex health needs across several areas. The assessment looks at:

Nature: How your condition affects you medically
Complexity: How difficult your needs are to manage
Intensity: How much intervention you require
Unpredictability: How stable your condition is

The NHS assesses you across 12 care domains:

  • Breathing difficulties
  • Nutrition (eating and drinking)
  • Continence
  • Skin integrity (pressure sores, wounds)
  • Mobility
  • Communication
  • Psychological and emotional needs
  • Cognition (memory, understanding)
  • Behaviour
  • Drug therapies and medication management
  • Altered states of consciousness
  • Other significant needs

Important: Having needs in these areas doesn’t automatically mean you’ll get funding. The assessment looks at the overall picture—how severe, complex, and unpredictable your health needs are.

Who Typically Qualifies?

People who often qualify for NHS Continuing Healthcare include those with:

  • Advanced cancer or terminal illness
  • Severe dementia with complex behaviours
  • Serious neurological conditions (advanced Parkinson’s, MS, motor neurone disease)
  • Brain injuries requiring complex care
  • Severe stroke with multiple complications
  • Complex wound care needs
  • Conditions requiring continuous medical management

Who typically doesn’t qualify:

  • Frail elderly people needing help with daily tasks
  • Those with mild to moderate dementia
  • People recovering from surgery or illness
  • Those needing social care rather than medical care

The Hard Truth

Only around 15% of people assessed for NHS Continuing Healthcare qualify. The criteria are strict, and many families are disappointed when their application is refused.

How to Apply for NHS Continuing Healthcare

Step 1: Initial Checklist

The process starts with a simple checklist completed by a healthcare professional (GP, hospital discharge team, or social worker). This determines whether you should proceed to a full assessment.

Who can request this: You, your family, or any healthcare professional involved in your care.

Step 2: Full Assessment

If the checklist indicates you might qualify, you’ll have a full assessment by a multidisciplinary team (MDT). This usually includes:

  • A nurse
  • A social worker
  • Other relevant healthcare professionals

They’ll assess you across all 12 care domains and assign ratings (no needs, low, moderate, high, severe, or priority) to each.

Step 3: Decision

The Clinical Commissioning Group (CCG) or Integrated Care Board (ICB) reviews the assessment and makes a funding decision, usually within 28 days.

Fast Track Pathway

If you have a rapidly deteriorating condition and may be approaching end of life, there’s a Fast Track process. A doctor or specialist nurse can complete a Fast Track Pathway Tool, which should result in immediate funding without the full assessment process.

This is typically for people with:

  • Terminal cancer
  • End-stage organ failure
  • Rapidly progressing neurological conditions
  • Other life-limiting illnesses

What If You’re Refused?

Many initial applications are refused. If this happens:

1. Ask for a detailed explanation
Request specific reasons why you didn’t meet the criteria.

2. Request a review
You have the right to ask for the decision to be reviewed by the local NHS appeals panel.

3. Consider an Independent Review
If the local review also refuses funding, you can apply to NHS England for an Independent Review Panel.

4. Get support
Organisations like Age UK, the NHS Continuing Healthcare Alliance, and independent advocates can help with appeals.

Don’t give up after the first refusal—many successful claims are only approved after appeal.

Other NHS Support for Care at Home

Even if you don’t qualify for full NHS Continuing Healthcare, other NHS support might be available:

Intermediate Care

Short-term support (usually up to 6 weeks) after a hospital stay or illness to help you recover at home. This is free and can include:

  • Physiotherapy
  • Occupational therapy
  • Nursing care
  • Personal care
  • Equipment provision

Reablement Services

Free short-term support (typically 6 weeks) to help you regain independence after illness or injury. Your local authority arranges this, but it’s funded by the NHS and council jointly.

Community Health Services

Free NHS services you can access at home:

  • District nurses for wound care, medication, catheter care
  • Community physiotherapy
  • Occupational therapy assessments and equipment
  • Community mental health teams
  • Continence services
  • Community palliative care teams

These services are free but don’t cover personal care (help with washing, dressing, eating) or domestic tasks.

If the NHS Won’t Pay: What Are Your Options?

1. Local Authority Funding

If your care needs are primarily social rather than medical, your local council may help fund care through social services. This is means-tested based on your savings and income.

Eligibility criteria:

  • Savings under £23,250 (England) to receive any support
  • Asset and income assessment determines contribution

Your local authority will conduct a care needs assessment to determine:

  • What support you need
  • Whether you meet eligibility criteria
  • How much you can afford to contribute

Learn more about how to get funding for home care.

2. Self-Funding

If your savings exceed the threshold or you don’t meet eligibility criteria, you’ll need to pay for care yourself. This might involve:

  • Using savings or income
  • Equity release from your property
  • Financial support from family
  • Insurance products

Discover how much home care costs.

3. Benefits

Even if the NHS won’t pay for care at home, you might qualify for benefits to help with costs:

Attendance Allowance
£72.65 or £108.55 per week (2024/25) for people over State Pension age who need help with personal care

Personal Independence Payment (PIP)
For working-age people with disabilities (under State Pension age)

Carer’s Allowance
£81.90 per week for family members providing 35+ hours of care

These benefits aren’t means-tested and can be used towards care costs.

4. Combined Funding

Sometimes care is funded through a combination:

  • NHS funding for healthcare elements
  • Local authority funding for personal care
  • Self-funding for additional services

This is called a “joint package” and is arranged through your local Clinical Commissioning Group and social services.

Common Myths About NHS Funding for Home Care

Myth: “The NHS pays for all care for elderly people.”
Reality: The NHS only pays when care needs are primarily medical, not age-related frailty.

Myth: “If you have dementia, you automatically get NHS funding.”
Reality: Only if dementia causes severe, complex needs. Mild to moderate dementia usually doesn’t qualify.

Myth: “You can’t get NHS funding if you own your home.”
Reality: NHS Continuing Healthcare isn’t means-tested. Your assets don’t matter—only your health needs.

Myth: “Hospital discharge teams will tell you about NHS funding.”
Reality: You often need to ask specifically. Many families miss out because they weren’t informed.

Myth: “Once refused, you can’t apply again.”
Reality: You can request reassessment if your health deteriorates or circumstances change.

Questions to Ask Healthcare Professionals

When discussing care needs, ask:

  • “Could I qualify for NHS Continuing Healthcare?”
  • “Can someone complete the CHC checklist?”
  • “What specific health needs would make me eligible?”
  • “If I don’t qualify now, what would need to change for me to qualify?”
  • “What other NHS support is available?”

Don’t assume someone will automatically tell you about NHS funding—you need to ask.

How Lidder Care Can Help

At Lidder Care, we have extensive experience supporting families through the NHS funding process. Whilst we can’t influence funding decisions, we can:

Provide clarity
Help you understand whether NHS funding might be realistic for your situation

Support your application
Assist in gathering evidence and documentation that demonstrates your health needs

Coordinate with healthcare professionals
Liaise with GPs, district nurses, and assessment teams

Offer alternatives
Explain other funding options if NHS funding isn’t available

Deliver flexible care
Provide home care services that work with various funding arrangements—NHS, local authority, or self-funded

Our Services

We offer comprehensive home care across Mansfield and surrounding areas:

If home care isn’t suitable, we also operate:

Taking Action

If you think you or a loved one might qualify for NHS funding for care at home:

1. Request a CHC checklist
Contact your GP, hospital discharge team, or social worker

2. Gather evidence
Document health needs, medication, GP visits, and care requirements

3. Don’t delay
If someone’s in hospital, request assessment before discharge

4. Get professional advice
Speak to care providers experienced in NHS funding

5. Be persistent
Many successful claims require appeals, so don’t give up after initial refusal

Get Expert Guidance

Understanding NHS funding for care at home is complex. Our experienced team can help you navigate your options and find the right solution—whether that’s NHS funding, local authority support, or private care arrangements.

Contact Lidder Care:

Phone: 01623 622 322
Get in touch today

We offer free consultations to discuss your circumstances, explain realistic funding options, and help you access the care you need.

Related resources:

The key is understanding your options early and getting the right support to navigate the system effectively.

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