NHS funded nursing care in England and Wales

In this section, when we talk about your nursing home co-ordinator this means care home co-ordinator in Wales; and when we talk about your local Primary Care Trust this means health board in Wales.

If you live in a care home in England or Wales you may be able to get help with the cost of your nursing care. Before entering a care home you should arrange an assessment from your local Primary Care Trust (PCT)  – see 'non-means tested help'. If your PCT thinks that you need nursing care, it should organise for you to be assessed by a registered nurse. If the nurse assesses you as needing nursing care, the NHS will pay an amount directly to the care home towards the cost of your nursing care.

• If you pay your own fees this should mean that you see a reduction in how much you have to pay.
• If most of your fees are paid by the local council the NHS will still contribute towards the cost of your nursing care, but the amount you pay will not be affected.
• If you pay part of your fees and the local council pays part of your fees, you may get a reduction. If you’re in this position check with your local council or get advice from SeniorLine on 0808 800 6565.

In England, the amount the NHS will contribute toward nursing care costs changed on 1 October 2007 to a flat rate of £101 per week for those people newly assessed as needing nursing care.

Transitional arrangements for existing claimants

Those people who have been already been assessed as needed nursing care will be reassessed. For people who were previously assessed as needing the middle or lower rates of nursing care, and who are still assessed as needing this level of care, your care home will now receive the flat rate of £101 per week for your care.

For people who were previously assessed as needing the higher rate of nursing care, and who are reassessed as still needing this level of care, your care home will continue to receive the higher rate of £139 per week.

If you live in Wales, your care home will receive a flat rate of £117.66 per week towards you fees.

Your care home has to give you a statement detailing how much the NHS is contributing to your nursing care and how this affects your fees.

Once you have been assessed by an NHS nurse you will receive regular reviews of your nursing care needs. The reviews should take place within three months of your assessment and then yearly. If, at any time, your nursing needs change, your care home should notify the NHS nursing home co-ordinator at your local Primary Care Trust.

If the NHS nurse decides that you do not require any nursing care the NHS will not be obliged to pay for it, and neither will the local council. If you still wish to go into a care home offering a high level of nursing care, you can only do so if you agree to pay for the nursing aspect of your care yourself.

If you disagree with the level of nursing care that you have been assessed as needing, you can ask to be referred to the Primary Care Trust continuing care panel for a review. If you are still dissatisfied, you can ask the Healthcare Commission for a further review.

If you are entering nursing care for a period of less than six weeks you will not need to have an assessment by an NHS nurse.  For the remaining part of your fees, covering personal care and accommodation costs, you will still be assessed under the rules on stated in 'Rules on savings and capital'.

The Government has announced that the rates for nursing care costs will remain effective in the new  financial year, 2008–09, until further announcements are made later this year. 

Our free advice service SeniorLine can give you advice on how these rules will affect your particular situation. Call free on 0808 800 6565.

If you’re assessed as needing nursing care, it is worth checking whether you have been properly assessed for fully-funded NHS care first – see 'Fully funded NHS Care'.

Nursing care contribution in Northern Ireland

If you are funding all or part of your nursing home fees you may be able to get help with the cost of your nursing care. Nursing care is care that is provided, delegated or supervised by a registered nurse.

First, you need to be assessed by a Health and Social Care trust (HSC) nurse. If they agree that you need nursing care, your local HSC trust will pay up to £100 a week towards your care fees, depending on how much you are contributing towards the cost of your nursing home.

• If you are paying the full cost of your fees and are assessed as needing nursing care, the HPSS should contribute £100 towards the cost of your nursing home.
• If the HPSS is already contributing something towards your nursing home fees, its contribution will be increased to £100.
• If the HPSS is already contributing more than £100 towards your nursing home fees, you will not get any extra help and will continue to pay the same fees.

The HPSS nursing care contribution will be paid directly to your nursing home. You should then see a reduction in the fee that you have to pay. Payment should be backdated to the date you first requested a nursing care needs assessment.
Your nursing care needs will be reviewed after three months and then every year after that.

If you disagree with the decision made by the nurse you have a right to a review of the decision. Ask the nurse about the review process.

You will not normally need to have an assessment of your nursing needs if you are entering nursing care for less than eight weeks.

You can get advice on these rules from our free advice service SeniorLine on 0808 808 7575.

Help with personal and nursing care in Scotland

If you are paying all or part of your care home fees, and are aged 65 or over, you may be able to get help with the nursing and personal care part of your fees. If you are not yet 65, you will only get extra help with your nursing fees.

First, you need to have your care needs assessed by your local council (see 'Local Council Funding'). If you are 65 or over and your local council agrees that you need personal care it will pay £149 a week towards your care. If you are any age and require nursing care the council will pay an additional £67 a week.  These payments will be made by your local council to your care home. You should then see a reduction in the fees you have to pay.

Personal care is defined as:

• help with washing, bathing and showering
• help with managing continence including using continence equipment such as catheters and stomas
• assistance with eating, managing special diets and preparing specialist meals such as puréed food 
• help to move around indoors
• help with simple treatments such as applying creams, lotions and dressings.

Nursing care is defined as:

• care provided by a registered nurse or doctor.

You will still have to pay for normal accommodation costs which do not involve personal or nursing care, and your finances will be assessed to see how much you should pay. You should use the information in 'Rules on savings and capital' as a guide to how much you are likely to be charged. For further advice contact our free advice service SeniorLine on 0808 800 6565.