When a loved one falls ill and needs nursing care, families are often faced with difficult emotional and financial decisions. Many assume that care home fees must be self-funded – but that’s not always true.
Thousands of people across England and Wales have been wrongly paying for care that should have been fully funded by the NHS – unaware they’re entitled to full funding or having received an incorrect assessment of their eligibility for financial support.
If you or a relative have paid nursing or care home fees, a Nursing Care Fee Recovery Claim could help you recover those costs.
What is a Nursing Care Recovery Claim?
A nursing care recovery claim (sometimes called a Continuing Healthcare claim) is a process where individuals or families reclaim money for care home fees that should have been covered by the NHS Continuing Healthcare (CHC) scheme.
NHS CHC is a package of care arranged and funded solely by the NHS, provided either in a care home or in your own home. It applies when an individual’s need for care is primarily due to complex, intense, or unpredictable health needs regardless of their personal finances.
If your relative was in a care home because of a physical or mental health condition, there’s a real possibility that the NHS should have been covering the cost.
Who can make a care recovery claim?
You may be eligible to make a claim if:
- You or a loved one have been paying care home fees, either currently or in the past.
- The care was required primarily due to health needs (for example, dementia, Alzheimer’s, Parkinson’s Disease, a severe stroke or other long-term conditions).
- You believe the NHS should have covered the cost under Continuing Healthcare.
- The person receiving care has since passed away – families can still claim retrospectively on their behalf.
In England, retrospective claims can go back to April 2012, while in Wales they can cover up to 12 months before the date of application.
If you’ve had a current assessment from the NHS there are strict timeframes in which to appeal. In England, you must appeal within 6 months of receiving a letter to notify you that you have been found not eligible for funding. In Wales, it is 28 days.
How the claims process works
The claims process depends on your situation, whether you’re starting from scratch, appealing a previous NHS decision, claiming for someone who has passed away or has just moved into long-term care.
The first step is simple: complete a short questionnaire on the Hugh James website. Their specialist Nursing Care team will review your information for free and let you know whether you have a case. There’s no obligation to proceed if you choose not to.
Complete the questionnaire
If your case is accepted, Hugh James will handle the full claims process on your behalf: gathering medical evidence, preparing legal arguments, and dealing directly with the NHS.
Retrospective eligibility
To claim retrospective eligibility, Hugh James will need to show that an individual’s health and nursing care needs were more than what a social services department could provide.
If that’s the case, then their primary need would be for health and they would have been entitled to full NHS funding. In England we can consider unassessed period of care from April 2012 and in Wales a claim can be no longer than 12 months from the date an application is made. A claim can still be made if the person in care has since died.
The Pearson Family: a case study
When Kath Pearson was diagnosed with Alzheimer’s, her family made the heartbreaking decision to move her into a residential care home so she could receive the care she needed. Like thousands of other UK families, no one informed them about NHS Continuing Healthcare (CHC) funding – even when having meetings with social services about Kath’s care funding.
To fund her care, Kath’s family were forced to sell her home and use all of her life savings – more than £250,000 in total.
It was only in the final year of Kath’s life that her family discovered they could apply for NHS CHC funding.
They got in touch with the Hugh James Nursing Care team and a current assessment and a retrospective review was requested. Mrs Pearson was deemed eligible, and the NHS met her ongoing care fees – the £2,500 per month in care fees.
But her family felt it was unfair that people like Kath are left with nothing to pass on to their children and grandchildren when there is funding available which they are entitled to but are being denied.
The family felt that she should have been eligible for NHS continuing healthcare much earlier on and so wanted to make a retrospective claim.
After many appeals, and with the help of Hugh James’ expert team, the family not only successfully recovered £40,000 in wrongly paid fees.
Read more case studies
Why choose Hugh James?
Hugh James are national experts in care fee recovery. Since setting up their dedicated Nursing Care department in 2006, they’ve helped families recover over £250 million in wrongly paid care home fees.
With over 40 specialist lawyers focusing solely on NHS Continuing Healthcare claims, they’ve worked alongside leading charities supporting older people and carers.
As fully regulated solicitors, they have transparent costs with funding options, including “no win, no fee” agreements and an hourly rate basis.
Making a claim can be a complex and emotional journey, so we recommend Hugh James for taking the stress out of the process by guiding families through with compassion and expertise.
Your loved one’s care should never have cost you their life savings. If you think you or a loved one may have wrongly paid care home fees, don’t wait – you could be entitled to thousands of pounds in financial redress.
Make a claim
Not keen on third parties?
Not everyone wants legal support and that’s okay. If you’d rather manage your claim on your own, you’re fully entitled to do so. We’ve put together a free guide that walks you through each step of the NHS Continuing Healthcare process so you can take control with clarity and confidence.
Read our free guide