Health –v- Social Care Needs. How does this affect you?

At Cartmell Shepherd our Health and Social Care Team, with support from our Private Client Team, advise on all aspects of health and social care law including funding care.

The current funding system is based on whether your “primary” need is for “health care” – provided by the NHS and free at the point of delivery – or “social care”  – which must be paid for privately unless you qualify for Local Authority funding.

If you or your loved one has care needs then if they are eligible for NHS Continuing Healthcare (NHS CHC) all of their care will be funded by the NHS, which could result in a huge financial benefit in the long term.

The assessment process focuses on a person’s needs, rather than any underlying medical condition which can mean that a person’s needs are classed as social even though the reason they need care is because they are ill.

Social care includes routine help with personal care, for example washing and dressing, help with meals and staying safe.  Someone with a primary health need would need more complex care, for example because they are not compliant with their care, or their behaviour puts themselves or others at risk, or because their needs are unpredictable.

If you or a loved one starts to need care – for any reason and at any age – or care needs change then your care needs must be assessed and it must be considered whether you may be eligible for NHS CHC.  Many people are not aware of this and also may not realise that decisions not to assess, as well as the outcome of assessments, can be challenged.

Clearly, establishing whether you have a health need or a social care need is critical in terms of who will pay for your care.

As both the NHS and local authorities feel the strain, politicians and commentators are increasingly looking at the health and social care divide and questioning whether it should continue.  There is concern that the divide increases public costs overall and risks failing to deliver the care people need.

Interestingly, in the recent Cabinet re-shuffle Jeremy Hunt’s department was re-named the Department of Health and Social Care.

The Government has been rolling out schemes to increase co-ordination between the two but these are not without controversy with a group of health campaigners, including Professor Stephen Hawking, recently obtaining permission to judicially review the Government’s plans to introduce Accountable Care Organisations  – where various local partners come together to deliver health and social care in their local area, following a bidding process  –  for fear this could lead to privatisation of the NHS.  There will be further consultation and scrutiny on the issue.

The Government also announced, in November last year, that it will publish a Green Paper this Summer in relation to social care for older people, with two Government departments jointly reviewing care for younger adults.

Perhaps we shall see major reforms in this area in the future.  For now the distinctions between health and social care remain – and the consequences for paying for that care.

At Cartmell Shepherd we offer expert advice and support in all areas concerning care, including funding care, hospital discharge planning, choice of care setting and challenging care assessments and packages.

We have in depth knowledge and long standing experience in the specialist area of NHS CHC assessments and eligibility.  We can advise and support you through the often difficult and emotionally demanding process, including attending assessments with you and we can help you request assessments and challenge decisions.

We also advise on Local Authority means testing and the disputes which can arise over how your assets are taken into account.

If you or a loved one has a health or social care problem or query – whatever their age –  please contact Stephanie Johnson, Head of Health and Social Care Team, on 01228 516666.


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Throughout my claim, I felt completely confident that you had my best interests at heart. The advice you gave us throughout was clear and not misleading, and again I felt the advice given was best for me, not best for you or your firm.

Client 28th May 2015