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02 August 2012
If you or a relative have been paying nursing home fees and your needs are primarily health needs, you may be entitled to reclaim those fees – but you need to act now, or you could miss the Department of Health’s deadline, says a leading south east law firm.
The NHS has an obligation to pay for the cost of long-term care if the primary need is health related, rather than a social care need, says chartered legal executive Val Prosser, a member of the Elderly Client Team at Furley Page.
“If a relative was paying for their own care right up until they died, it’s also possible to lodge a retrospective appeal for NHS Continuing Care – but time is running out,” warns Val.
“Deadlines set by the Department of Health mean that if a relative in care died between 1 April 2004 and 31 March 2011, a claim must be registered by 30 September 2012. If your relative died between 1 April 2011 and 31 March 2012, you have until 31 March 2013.”
NHS Continuing Care is a package of services arranged and funded by the NHS for people outside hospital with ongoing physical or mental health needs, whether you’re in your own home or a care home.
So how does a relative in care qualify for NHS Continuing Care? First they will be assessed to ascertain the level of care they require. There are 12 areas that will be considered: behaviour; cognition; psychological and emotional needs; communication; mobility; nutrition (food and drink); continence; skin (including tissue viability); breathing; altered states of consciousness; drug therapy and medication; and other significant care needs.
If a relative’s care needs improve then the NHS Continuing Care package can be withdrawn. However, even if the care home is successfully managing a need, this may still qualify because the need still exists. Only where successful management has permanently reduced a health care need will eligibility be affected.
Says Val: “The rules concerning the appeals process can be very complex and confusing so if you or a relative feel you have been paying for care which, due to health needs, should have been fully funded by the NHS, it’s important to speak to an expert. With these new deadlines looming, you should seek advice as soon as possible. If the claim is successful, substantial amounts paid out for care fees can be reclaimed.”
Val Prosser is a member of Solicitors for the Elderly and is a specialist in advising upon and dealing with reclaiming fees which have been paid unnecessarily.
For further advice, contact Val on 01227 763939.