NHS funded nursing care: what it is and who gets it

A nursing home has registered nurses on duty around the clock. Their work, such as managing medicines, wound care and monitoring conditions, is healthcare, and in England healthcare is free. Funded nursing care is how the NHS pays for that part of a nursing home place while you or the council pay for the accommodation and personal care.

It exists because the line between health and social care runs straight through a nursing home. Rather than argue about each task, the NHS pays a standard weekly contribution for everyone who is assessed as needing nursing.

You get funded nursing care if all three of these are true:

• you live, or are about to live, in a care home registered with the CQC to provide nursing (see types of care home)
• an assessment finds you need care from a registered nurse, rather than care a trained care worker could give
• you are not eligible for NHS Continuing Healthcare, which would cover everything

It does not matter how much money you have. Self-funders get it on exactly the same terms as people the council pays for. It does not apply in a residential home with no nurses, even if a district nurse visits you there.

The money is paid by your local integrated care board to the home. It is a contribution to the home’s costs, not a payment to you, so you will not see it arrive in your account. What you should see is a fee that is £254.06 lower than it would otherwise be.

Ask the home to show the nursing contribution as a separate line. If it does not, ask why.

1. 01
   Continuing Healthcare checklist first

   Before anyone considers funded nursing care, a nurse, social worker or other professional completes the NHS Continuing Healthcare checklist. If it suggests you might qualify for full NHS funding, that is assessed first.
2. 02
   Nursing needs assessment

   If you are not eligible for Continuing Healthcare, a registered nurse assesses whether you need nursing care. It normally happens in the home, and you or a relative can be present.
3. 03
   Decision and payment

   The integrated care board confirms eligibility and starts paying the home, backdated to the date you became eligible. The home should adjust your invoice.
4. 04
   Review

   Your needs are reviewed after three months and then at least once a year, or sooner if they change. If you no longer need nursing the payment stops, and the question of whether you still need a nursing home comes up too.

Homes handle the money in one of two ways. Some quote a fee that already has the nursing contribution taken off, so a self-funder sees one figure and pays it. Others quote a gross fee and show the NHS payment as a deduction. Either is fine as long as the arithmetic is visible. What is not fine is a home quoting the same fee whether or not you receive funded nursing care, which means the home is keeping it.

When the rate rises in April the reduction on your bill should rise with it. Homes also raise their own fees in April, so the two changes often land in the same letter. Check both numbers.

The two are often confused. Funded nursing care is a fixed contribution towards the nursing part of a nursing home fee. NHS Continuing Healthcare is a package that pays for all of your care, wherever you live, if your needs are found to be primarily about health. Continuing Healthcare is far harder to get and is always considered first. If you are refused it, funded nursing care is the fallback for anyone in a nursing home, and you can still challenge the Continuing Healthcare decision later.