Funding 

Additional Details

Continuing Healthcare Funding (CHC):

Self- funding:

You will not be entitled to help with the cost of care from your local council if:

  • you have savings worth more than £23,250 – this is called the upper capital limit (UCL)

  • you own your own property (this only applies if you're moving into a care home)

 

You can ask your council for a financial assessment (means test) to check if you qualify for any help with costs.

A financial assessment or means test works out if the council will pay towards your care. It looks at how much money you have.

In England the council generally helps to pay for care costs if you have savings less than £23,250.

It may be that you'll have to pay towards the cost of your care. The more money you have, the more you'll be expected to pay.

Personal Health Budget:

A personal health budget is an amount of NHS money that is allocated to support your health and wellbeing needs. If you're eligible for it, you (or someone who represents you), will work with your local NHS team to plan how you spend the money and get the care you need.

A personal health budget allows you to manage your healthcare and support such as treatments, equipment and personal care, in a way that suits you. It works in a similar way to personal budgets and direct payments which allow people to manage and pay for their social care needs.

Who can get it?

The right to have a personal health budget applies to people who are:

  • adults receiving NHS continuing healthcare (NHS-funded long-term health and personal care provided outside hospital)

  • children receiving NHS continuing healthcare

  • people who are referred and meet the eligibility criteria of their local wheelchair service and people who are already registered with the wheelchair service when they need a new wheelchair or specialist buggy, either because of a change in clinical needs or the condition of the current chair. These people will be eligible for a personal wheelchair budget.

  • people with a mental health condition who are eligible for section 117 after-care as a result of being detained under certain sections of the Mental Health Act (this does not include detention under section 2 of the Act).

 

Personal budgets and direct payments

You'll be given a personal budget to spend if your local council decide you're eligible for help with any social care and support you need. You can request an assessment from the council to establish your needs.

Your personal budget is the amount of money your local council will pay towards any social care and support you need.The money in your personal budget can be paid to you, to help you make more decisions about how it's spent. This is known as a direct payment.

The amount of money in your personal budget is decided by your local council after getting a needs assessment to work out the following:

  • what kind of care and support you need

  • how much it will cost

  • how much you're able to afford yourself

Direct Payments:

Direct payments give you more flexibility over how your care and support is arranged and provided.

For example, you could choose to hire care workers or personal assistants who:

  • are always the same people and available when you need them

  • speak the same language as you

  • have experience working with your care needs

  • are a specific person that has been recommended to you

  • can help you get to shops or social events

There are many ways you could choose to use the money. It's your choice as long as you're spending your personal budget on things that meet your agreed care plan.

Most councils will ask for evidence of how you've spent your money every 3 months.

When to consider other options

You may decide direct payments are not helpful if:

  1. you're worried about managing money or the people you employ

  2. you spend a lot of time in hospital

  3. you would rather the council arranged your care

 

If you are not confident about keeping records or managing the people who care for you, your local council should be able to provide support.

You could also consider having someone else manage your direct payments, for example a friend or family member. You'll need to set up a trust for payments that are managed by someone else.

Care and Support you can get for free:

In cases of complex health needs, the NHS may provide funding, covering the full cost of your care. 

To qualify for NHS Continuing Healthcare funding, you must be aged 18 or over and have a "primary health need," which means your overall care needs are mainly for health rather than social care. 

Eligibility is determined by a professional multidisciplinary team professional through a two-stage assessment (checklist and full assessment), focusing on the nature, complexity, and intensity of your needs, not on your diagnosis. 

The assessment covers various needs, including breathing, nutrition, mobility, communication, and behaviour, to decide if your care needs are significantly health related.

There's some help and support you can get for free that's available to everyone.

It's not means-tested and it does not matter what your income is.

This free care includes:

  • some equipment and home adaptations

  • benefits

  • help after coming home from hospital

  • NHS continuing healthcare

  • nursing in a care home (NHS-funded nursing care)

 

Free home adaptations and equipment

You may be entitled to free home adaptations and equipment provided they cost less than £1,000 each.

The type of adaptations and equipment this includes are:

  • handrails for the stairs

  • grab rails for the bathroom

  • an intercom system for answering your front door

  • ramps for wheelchair access

  • a walking frame

  • perching stools in your kitchen or shower

  • heating system improvements (if it directly affects your medical condition)

If the hospital gives you any equipment to use when you get home, such as a toilet surround frame, this should also be free.

How do I get it?

Ask the adult social services department of your local council for a home assessment. You can do this online or by telephoning them.

An occupational therapist will visit you at home to see what you need.

If the assessment finds you need a change to your home or a piece of equipment that costs less than £1,000, the council must provide it free of charge.