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eleafletWhat if I need care mostly because of health problems?

If you have ongoing health problems and need help with caring for yourself, you may be entitled to 'NHS continuing care'. The NHS should arrange and pay for this care. Find out more about the assessment process to decide if you are eligible here.

What if I need care mostly because of health problems?

If you have ongoing health problems because of a disability, an accident or illness, or you're coming out of hospital, then you may need 'continuing care'. This can be a package combining healthcare and community care.

Your local primary care trust (in England) or local health board (in Wales) should arrange for an assessment to see if you are eligible for 'NHS continuing healthcare'.

If the assessment shows that you need continuing care mainly because of your health problems, the NHS should arrange it.

You should also have a continuing care assessment if you are coming out of hospital and it appears you might still need care.

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How is the continuing care assessment done?

In England, there are usually two stages in a continuing care assessment. First, the person assessing you will go through a basic checklist, to see if your main need appears to be health-related.

If it does, then you will get a full 'multi-disciplinary' assessment using another checklist called a 'Decision Support tool'. This assessment involves all relevant health and community care professionals looking at your needs. The final decision lies with the primary care trust or health board.        

If the initial check  doesn't show that your main need is health-related, you can still ask your primary care trust to give you a full assessment.

In Wales, and sometimes in England, you can miss the initial stage and go straight to a full continuing-care assessment if you clearly need it.

The primary care trust should normally tell you whether you are eligible for NHS-funded continuing care within two weeks of having a full assessment.

For more about the assessment process, see the Department of Health leaflet on NHS continuing healthcare.

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What care will I get?

NHS continuing healthcare might be a package of medical care with social services' support. You might receive it in your home, or in a care home or nursing home. In either case, the NHS should pay for all the care.

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What if I'm not eligible for NHS continuing healthcare?

If the primary care trust or local health board decides that you're not eligible for NHS continuing healthcare, you may have to pay for the non-medical parts of your care. However, you will still be entitled to free NHS primary health care (that is, medical or nursing care), whether you're at home or in a care home or nursing home.

See Moving into a Care Home for more about the different elements of care in care homes and nursing homes, and who pays for what.

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What if my needs change?

If your needs change, you may become eligible for NHS-funded continuing healthcare even if you weren't before. Ask to be assessed again.

If you are receiving NHS continuing healthcare or the NHS is providing some of your care, your case should be reviewed within three months of the original assessment and at least once a year after that. And you can ask to be re-assessed at any point if your needs change.

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