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"Thanks so much for all your help, advice, patience and effort from day one to today - I can’t imagine how this would have turned out without your skill and stamina."

- A son acting for his mother in a care fees dispute

"Your impact has definitely been felt by all involved, it’s efficient, intelligent and dynamic. I can feel that the opposing party are raising their standards, as soon as they hear from you."

- Sister of disabled man challenging care package

< Back to care journey

The duty of the NHS includes the provision of services for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness.

The duty of a social services department is to support a person's well being by assisting them with developing or maintaining their social engagement. They may provide health services in support of that but cannot do so if the health services are more than an ancillary or incidental aspect of the overall accommodation service being provided or if the nature of the health care provided is not the kind of care that a social services department can be expected to provide.

Whether or not a person is eligible for full NHS funding has important financial consequences. NHS funding is free. If the person is not fully NHS funded then subject to a means test, in residential care  they will have to pay for their care in full. If they cannot afford to pay in full, they will even so have to make contribute nearly all of their income which even for basic state pensioners amounts to several thousand pounds a year. 

If care is provided at home, the council has more discretion but many councils have now moved to a full cost charge subejct to a means test.

The test of eligibility is far from straightforward.  It is a common experience that a different assessment team conducting a review may take a different view even when there has been little change in the patient's needs.

The quality of assessments has been a problem recognised by health authorities themselves.

The question you should ask yourself, is "does it seem to me as if the care given to me is to support my social engagement or am I really just being nursed due to health problems (even if it is by non nursing staff)?"

If the answer is that you feel you are (or your relative is) being nursed, legal advice is recommended.

A common issue is that nursing home residents with late stage neuro-degenerative disease such as Alzheimers disease are expected to pay for their own health care. This is even though they are suffering from extensive damage to the brain, have little or no social functioning which a social services department can support and are completely dependent upon staff to maintain their life. The rationale for this may be that the care that they need is not health care but "social care." These cases should be challenged because this rationale is wrong.

You may be interested in our recent news articles: 

NHS continuing healthcare: why you may lose –update 2020 NHS continuing healthcare: why you may lose


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30 Jul 2021

Regulations to make Coronavirus vaccination compulsory for most care home staff are signed into law

Vaccination requirement will apply to most people working in CQC regulated care homes from 11 November 2021.

28 Jul 2021

But I am his deputy, why has the Official Solicitor been appointed as his litigation friend?

New guidance from the Court of Protection on appointing the Official Solicitor in both personal welfare and property, and affairs proceedings.

27 Jul 2021

Residential property developer tax and community-led housing

Will the proposals for financing the removal of Grenfell-style cladding affect community-led housing groups?