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Yvonne Goodwin: Care sector hiding an elephant in the room

In September, I wrote about addressing the elephant in the room that is the fact elderly clients’ financial plans can get derailed through ill health. My request was based on recent personal experience of the NHS and its associated frustrations.

Well, this month I have managed to find an even bigger elephant in the room (you might say woolly mammoth) that no one in the NHS or local authority wants you to know about.

Advisers armed with the information will be able to deliver significant value to clients during difficult times.

With all the people involved in my mother’s care, it became apparent she was unable to go back to independent living within her sheltered housing complex.

At a meeting with the rapid response team social worker, it was agreed that she would need residential care.

My sister and I were given the unenviable task of finding a suitable care home for her.

The nurse present at this meeting mentioned something which the social worker quickly brushed away as not required.

Perhaps I have been around in financial services for too long, but it stuck in my mind to the point I went away and did some research. It was called NHS continuing healthcare.

In essence, everybody leaving NHS care, whether that be hospital, recovery hub or so on, has a right to be assessed for ongoing care arranged and funded by it. There is an initial checklist assessment that can be completed by a nurse, doctor, other healthcare professional or social worker.

If eligible, the patient will be referred for a further, full evaluation.

I quote from the national framework for NHS continuing healthcare, as updated with effect from 1 October: “Primary health need is a concept developed by the secretary of state for health to assist in deciding when an individual’s primary need is for healthcare (which it is appropriate for the NHS to provide under the 2006 Act), rather than social care (which the local authority may provide under the Care Act 2014).

“To determine whether an individual has a primary health need, there is an assessment process, which is detailed in this national framework.

“Where an individual has a primary health need and is therefore eligible for NHS continuing healthcare, the NHS is responsible for providing for all of that individual’s assessed health and associated social care needs, including accommodation, if that is part of the overall need.”

Up until this rapid response team meeting, no one had addressed this. Bearing in mind my mother had been hospitalised on 4 July and this meeting took place in mid-September, you would have thought there had been ample time.

A confession here too: I sat the long-term care exam in 2010, which covered this issue. Did I remember it? No.

All advisers should familiarise themselves with this. It could prove invaluable help to clients in this position themselves or who have parents in such situations.

You can find out more about this topic by visiting

Yvonne Goodwin is managing director of Yvonne Goodwin Wealth Management



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There are 4 comments at the moment, we would love to hear your opinion too.

  1. What the exams do not tell you is how difficult it is to get this assessment done and more importantly that if you disagree there is in effect no course of appeal. In theory there is but the reality is that the appeal will be delayed (thereby delaying additional funding in the expectation that the elderly person will die) and the appeal process in held behind closed doors and the relations of the person in care have no idea what is going on. I do have somewhere and address of a law firm that can assist but while the Government is quite happy to pour money into projects to win the next election, services like this get stuff all.

  2. I have recently gone through a similar situation with my father and felt that the whole assessment process was a complete farce. Even though in theory he qualified for continuing healthcare due to mobility, incontinence etc, he was turned down and I have yet to see the responses on the checklist. This is the elephant in the room. As a family we are now forced to pay £1,000 a week. And what ever happened to the £72,000 cap on care??? This was completely misunderstood by the public, and indeed politicians, and seen as a negative!

  3. It’s a mess.
    How about this, person receiving car at home goes in to hospital. Care package at home ceases while they are in hospital.
    Hospital look to discharge in due course. Family member with LPA says not to discharge until care at home back in place.
    Family member turns up at home to find them back in bed.
    Looks at them in bed and asks spouse of person in bed how on did the patient transport get her in to the flat and to the bed as whilst there was a left, it wasn’t long enough for a prone patient (as she was) and the hallway had a dogleg. Spouse didn’t know as the patient transport had accepted offer of a cup of tea, so all the shinanigens weren’t seen by a family member.
    When assessments are done’ they are done by BOTH NHS and local authority asking nearly exactly the same questions which LPA takes time off for to be present and assist and impression is they are just trying to make sure that the cost falls on the other ones budget.
    Nice staff and trying to help, but the system is well and truly ucked up.

  4. Paraplegic as a result of car accident and you get full funding, similar conditions as a result of MS and you get nothing.
    One thing I will say Phillip, if staff really cared they would do something about it. We do not want niceness.

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