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With effect from 1 April 2013, radical structural changes have been made across the NHS and, as a consequence, Clinical Commissioning Groups (CCGs) have now replaced Primary Care Trusts. In the context of NHS continuing healthcare funding  – i.e. when the NHS funds care costs for an individual who has been assessed as having a primary health need – the change means that CCGs are now legally responsible for the whole assessment process.

The Department of Health expects no major changes to continuing healthcare funding and the national threshold on eligibility remains broadly the same. Moreover, these changes do not affect current cases, including those being considered for retrospective continuing healthcare funding eligibility from 1 April 2004.

While the assessment process will remain the same, from April 2014, those people who have been assessed as being eligible for Continuing Healthcare Funding will have the right to request a Personal Health Budget (PHB). This will mean that the NHS will allocate monies to an individual with health needs to ensure those needs are met. This strategy aims to involve people at the heart of their health and care planning, rather than being passive recipients of it. It is noted, however, that PHBs are still being piloted and it also remains to be seen whether the CCG emphasis on “strategic commissioning” and “value for money” will not be at odds with the NHS constitution itself.

Nevertheless, CHC sits uncomfortably between health and social care, rendering it a highly complex area that continues to be the subject of litigation and Parliamentary Ombudsman decisions. With an ageing demographic, demand for healthcare funding will also increase for those who are assessed positively for it.

When placed in the context of average care fees outstripping pensioner income of around £31,000 (a sum that has increased at a rate of 8.7% in the South West last year alone), exploring CHC is vital in terms of ensuring that an individual has a comprehensive health MOT, but also, crucially, that capital and inheritances are preserved for future generations.

Are you currently paying for your own care? Do you have a friend or relative who pays for their care? For more information on this and continuing healthcare funding in general, contact our Private Client Services department or call us on 0117 904 6000.