Who pays for what across health and social care is anything but straightforward, and trying to navigate a path through this when there is an urgent or changing care need is invariably a difficult challenge.

Many people don't realise that there is a difference between health and social care, including that the former is free and the latter is means tested. For example, health care relates to needs which have to be administered by a registered nurse and it’s free, provided and funded by the NHS. 

In contrast, The Local Authority (as opposed to the NHS) is only bound to provide social care services and this is means tested. For example, an individual who requires support getting dressed in the mornings and with transferring from room to room does not require a qualified nurse to administer these tasks. In this case, it would fall into the Local Authority’s remit and would not be the responsibility of the NHS.

Typical Costs of Care

According to a recent survey referred to in The Times Newspaper (14 Nov 2017) , fees for residential care homes had risen by 9.6% in the previous 12 months. Based on a comparison of fees charged by 124 residential homes, the survey found that the average fees across Britain had reached £33,094 a year, £2,978 higher than a year earlier.

However, the cost of a care home, either residential or nursing, varies considerably by region and the level of services and facilities available.

Home care costs can also vary hugely depending upon location. As with care homes, there are significant regional variations and costs will also depend on what sort of care your client needs, how many hours of care they need and what times of the day and week they need it.

The Money Advice Service suggests a starting figure of £15 per hour with full time care during the day starting at £30,000 per annum.

Should the NHS Pay For My Care?

If you need care and haven’t been assessed for NHS funding or want to contest a decision for declined funding, this book by ‘Care To Be Different’ is aimed at giving you a headstart in understanding how the process works and what to do.

Establishing self-funder status

Key steps in establishing whether your care needs will have to be funded in part or in full by yourself or family include the following;

  1. Understanding the nature and extent of your care needs and the likely cost of meeting them.
  2. Understanding what care services you can secure free of charge from your local authority or other third party (e.g. charities and support services) to help meet these needs.
  3. If part of the need relates to health care, establishing whether you qualify for free NHS Continuing Health Care funding (NHS CHC) – don’t forget, if you do not currently qualify, but your health deteriorates, you may become eligible in the future.
  4. If you do not qualify for NHS CHC, establishing whether you qualifies for an NHS contribution to Registered Nursing Care.
  5. Understanding the extent to which your local authority will fund any assessed social care needs.
  6. Establishing whether you have any insurances that may cover some or all of your care costs.
  7. Understanding the impact (if any) that legislation may have on the funding of your care needs.
  8. Understanding your entitlement to state benefits.


Key Facts

  • One in eight people live for 8 years or more in a care home according to care annuities provider, JUST.
  • The UK has an ageing demographic.
  • Long term care if required, is on average the second largest form of expenditure in a lifetime after a mortgage.
  • Government budgets do not match the rising demand for care services.
  • Being able pay for your care affords you choice in terms of what care you receive, when you start receiving it, and where you choose to receive it.

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