An Outline of the Main Sources of Health and Social Care Funding

Introduction

Finding information about health social care funding can be likened with searching for the source of the Nile: Everyone knows it must exist somewhere. My aim in this article is to explain the principal sources of funding (primarily I address funding for domiciliary care) and provide links that you can follow for more detailed information. Just a word of caution here. I provide links to some of my own articles, which in some cases may contain figures that were accurate at the time. It is always worth bearing in mind that any figures cited may now differ.

Social Services Funding

Funding from social services is means tested. Therefore you may qualify and have to make no contribution; you may qualify and have to make a contribution, or you may not qualify. Prior to any means test being conducted, you will have to have a care needs assessment. This article explains about the care needs assessment. Although it refers specifically to Kent County Council, the principles stated apply wherever you are in England. This article explains about means tests. Again, it refers to Kent County Council but the principles are general.

If you qualify for social services funding you now have a choice. Social services can set up everything for you and that will suit many people. However, you will have been awarded what is called a personal budget. You can take this budget in the form of a direct payment. You can then use this money to purchase your own home care. If you have care from a private provider, you may well have to make a contribution from your own funds. Many people are happy to do this.

With a small number of exceptions, you have a right to a direct payment. A right that is enshrined in law - in the Care Act 2014. You do not have to have your home care through social services. You do not have to have your home care arranged by social services. You do not have to have your home care from a company recommended by social services. You have a right to choose; this right cannot be denied to you.

Social care funding is a controversial topic. You may recall that during the 2017 election the Conservative Party's manifesto proposals for funding social care were met with the most hostile criticism. The proposals were so badly received that is arguable that they contributed significantly to the Conservatives poor showing at the polls. I have been saying since then that history will not judge this government on brexit alone. It will judge it to a large degree on what - if anything - it does about funding social care.

Self Funding

If you do not qualify for social care funding you will have to fund your care yourself. This article offers you some advice about choosing home care. Essentially your choices are: use a private domiciliary care provider; employ you own carers directly; use self-employed carers. Option one is likely to be the most expensive. Options two and three clearly provide you with a financial incentive. There are, though, a few things to bear in mind. 

I go into a little detail about the things to bear in mind in this article. Although this article was written expressly about live-in care, the challenges of employing carers or using self-employed carers are identical whether you are talking about live-in care or other types of domiciliary care. In brief, if you employ a carer, you are an employer and have all the responsibilities that employers have. If you engage a self-employed carer who works exclusively for you, as far as HMRC is concerned you are an employer.

Continuing Health Care Funding

If you are assessed as having primary health need, You may qualify for financial support through NHS Continuing Health Care Funding. The NHS Choices website provides a very unhelpful circular definition of primary health need. Assessments are carried out by a multidisciplinary NHS team. There is no right to an assessment, but if it seems that you might need NHSCHC then the Clinical Commissioning Group (CCG) for your area must carry out an assessment. 

There is no means test for Continuing Health Care funding. As with social care funding there is a mechanism for you to have a personal budget, called a personal health budget. Once again, this is something to which you have a right, with a few exceptions.

Intermediate Care

There are occasions when you might need  little bit of help to maintain or regain your independence, for example, when you are due to be discharged from hospital. In such circumstances, you may qualify for intermediate care. This article explains about intermediate care. There is no means test for intermediate care.

Enablment or Reablement

The approach underpinning reablement is to help you to live your life independently. Reablement workers are not charged with the responsibility of doing things for you; they are responsible for helping you become confident and competent in doing things for yourself. This article gives more details. Again, there is no means test for those who qualify.

If you would like more information about any of the above, follow the links or telephone me at Caremark Thanet on the number below.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.