NHS Continuing Healthcare and LPA: What You Need to Know
NHS Continuing Healthcare and LPA: A Complete Guide
NHS Continuing Healthcare (CHC) can fund the full cost of care for people with complex health needs. But navigating the assessment process often requires someone to advocate on behalf of the person needing care. This is where having an LPA becomes essential.
What is NHS Continuing Healthcare?
NHS Continuing Healthcare is funding for people who:
- Have a "primary health need"
- Require ongoing care
- Have needs beyond what social services typically cover
What CHC Covers:
- Care home fees (fully)
- Home care packages
- Equipment and therapies
- Nursing care
- Some specialist accommodation
What It Means Financially:
- No means testing—your assets don't matter
- Care is free at the point of need
- Can save families £50,000+ per year
Why LPA Matters for CHC
The Problem
Many people who qualify for CHC lack mental capacity to:- Request an assessment
- Participate in the assessment process
- Challenge decisions
- Manage care arrangements
The Solution
With a Health & Welfare LPA, your attorney can:- Request a CHC assessment
- Attend assessments on your behalf
- Provide information about your needs
- Challenge decisions
- Accept or refuse care packages
The CHC Assessment Process
Step 1: Checklist Screening
Initial screening to see if full assessment needed. Attorney role: Can request this is completed, provide input.Step 2: Decision Support Tool (Full Assessment)
Detailed assessment of 12 care domains:Attorney role: Attend the assessment, provide evidence, ensure accuracy.
Step 3: Multidisciplinary Team Decision
Panel reviews the assessment. Attorney role: Can submit written evidence, sometimes attend.Step 4: Decision and Care Planning
If approved, care plan developed. Attorney role: Agree care arrangements, choose providers.How Your Attorney Helps at Each Stage
Requesting an Assessment
Anyone can request a CHC assessment, but having LPA gives your attorney authority to:- Access medical records (if specified)
- Speak to healthcare professionals
- Ensure the request is taken seriously
During the Assessment
Your attorney can:- Be present throughout
- Correct inaccuracies
- Provide additional information
- Describe needs from their perspective
- Advocate for proper scoring
Challenging Decisions
If CHC is refused, your attorney can:- Request a local review
- Escalate to NHS England
- Access the Independent Review Panel
- Gather supporting evidence
Managing Care
Once approved, your attorney can:- Agree care packages
- Choose care providers
- Monitor care quality
- Request reviews if needs change
Without an LPA
If someone needs CHC but has no LPA and lacks capacity:
- Family have limited formal rights
- Decisions may be made without proper input
- Appeals are harder to pursue
- Care arrangements may not reflect wishes
The Worst Case
The NHS/social services make decisions. You have no guaranteed voice.Court of Protection Option
Without LPA, family must apply for deputyship:- Takes 4-12 months
- Costs £2,000-5,000+
- Too slow for urgent care decisions
Property & Financial LPA and CHC
While Health & Welfare LPA covers care decisions, Property & Financial LPA is important for:
- Paying any top-up fees
- Managing finances during care
- Handling property if care home needed
- Applying for other benefits
What If CHC is Refused?
Appeal Rights
There's a formal appeal process:Attorney's Role
Your attorney can pursue appeals, access records, and advocate throughout. Without LPA, this is significantly harder.Common Reasons for Refusal:
- Needs deemed "social" not "health"
- Assessment errors
- Missing information
- Changing criteria interpretation
Retrospective CHC Claims
Families can claim for past care that should have been CHC-funded.
- Claims can go back to 2012
- Average successful claims: £30,000-100,000+
- Attorney can pursue on your behalf
When to Create LPA
Ideally: Before Care is Needed
Create LPAs while healthy, register them, and they're ready when needed.If Care is Already Needed
If someone still has capacity, create LPAs immediately. CHC applications often arise suddenly.If Capacity is Already Lost
Too late for LPA. Court of Protection is the only option.Practical Tips
1. Name Your LPA on Hospital Records
When admitted, ensure staff know about your LPA. They should involve your attorney in CHC discussions.2. Keep Medical Evidence
Your attorney should gather:- GP records
- Hospital discharge summaries
- Care assessments
- Professional opinions
3. Know the Criteria
Understanding CHC criteria helps your attorney advocate effectively.4. Don't Accept First Refusal
Many initial refusals are overturned on appeal. Your attorney should persist.5. Get Expert Help
CHC advocates and solicitors can assist. Your attorney can instruct them on your behalf.The Cost of Not Having LPA
Without LPA:
- Care may be self-funded when CHC should pay
- Families struggle to challenge decisions
- Assessment input is limited
- Years of care costs (£50,000+/year) mount up
Summary
- CHC can fund all care costs for those who qualify
- The assessment process requires active advocacy
- With LPA, your attorney can fight for your entitlement
- Without LPA, families have limited rights
- Create LPAs before care is needed
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*NHS Continuing Healthcare is complex. This guide provides general information. Seek specialist advice for specific cases.*
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