Can The NHS Pay For My Care?

Understanding Who Pays for Care

When you or someone you love needs long-term care, one of the biggest questions that you'll have is "Who pays for it?"

And it's a reasonable question. Care in the UK is expensive.

Understanding who pays for what can feel confusing, but it mostly comes down to whether your needs are health-related or social.

1. The NHS (National Health Service) which pays for health care, which is free and not based on your income.
2. The Local Authority (council), which pays for social care, which is means-tested, meaning that your savings and income are checked to see how much you must pay towards your care.

If your needs are mainly medical, you may get full NHS funding. If not, you may have to pay some or all of the costs yourself. The official term that you may see used when you're looking to get NHS funding is primary health need.

The NHS offers two types of help when it comes to funding care:

1. Continuing Healthcare (CHC) covers everything, meaning that you'll get full funding towards your care.
2. Funded Nursing Care (FNC) gives a smaller weekly amount to help cover nursing costs.

Full NHS Funding (Continuing Healthcare)

If someone's needs are mainly medical, the NHS can sometimes cover everything. Continuing Healthcare (CHC) covers all care costs if someone's health needs are very complex.

Unlike other funding options, it doesn't matter how much money, property or income the care receiver has. However, this funding option is only given to those with serious, ongoing health needs.

You don't need to have a specific illness or live in a certain type of home to qualify either. When deciding if someone qualifies for Continuing Healthcare funding, the NHS will look at four major things:

• Complexity: How complicated are your health needs?
• Intensity: How much and how often do you require care?
• Unpredictability: How often does your condition change suddenly?
• Risk: What could happen if you didn't get the right care in time? A team of health and social care professionals will carry out an assessment using a national checklist called the Decision Support Tool (link). Care receivers (as well as their families) are able to take part in this assessment too.

If approved, the NHS will pay for all care, including accommodation. If you're not approved, you might still get some help through Funded Nursing Care (FNC)

Partial NHS Help (Funded Nursing Care)

For those who require a registered nurse's help, but don't qualify for full CHC funding, Funded Nursing Care (FNC) is designed to help cover part of your care costs.

Funded Nursing care is a weekly payment that the NHS pays your care provider to help with nursing costs. Unlike Local Authority Funding, FNC is not means-tested, so anybody who needs a registered nurse is able to receive the funding.

Currently (in 2025 / 2026) the rate for FNC is £254.06 per week in England. While it's not a huge amount, it can help reduce the overall cost of care (with the average care home rates averaging around ~£1500 per week).

It's important to note that Funded Nursing Care only covers the nursing care costs. Things like accommodation, food and personal care must still be paid for by either yourself or the council, depending on your finances.

What If The NHS Doesn't Pay (Local Authority Funding)

If you don't qualify at all for NHS funding, you local council will step in. They'll conduct a financial assessment, and will look at your savings, income, and property value to decide how much you'll need to pay. This is called a means-test.

In England, the financial limits for 2025/26 are:

• If you have over £23,250 you will need to completely self-fund your own care.
• If you have between £14,250 - £23,250 then the council will pay, but you will still have to contribute to part of the costs (this is known as "tariff income")
• If you have less than £14,250 the council pays, however you'll still have to contrinute some income.

Sadly, most people have to use their savings or home value to pay for care. Across England, the average cost for residential care sits around £1,300 per week, while the cost for nursing care sits even higher at £1,500 per week.

Reviews and Appeals (If You Disagree)

If you've been turned down for NHS funding, don't give up just yet as you have a right to appeal. Remember, NHS funding decisions are not always final.

If your care needs have changed (for example, you've received a new diagnosis, or your health has deteriorated further), your funding can be reviewed after three months, then after that, once a year. Keep in mind however, that if your needs reduce funding can stop.

If funding is still refused and you disagree with the assessment results, you can also appeal the decision.

1. Ask for a local review by your Integrated Care Board (ICB)
2. If you're still unhappy, ask for an Independent Review Panel
3. If you believe there was a process error, contact the Parliamentary and Health Service Ombudsman. The Ombudsman can't overturn clinical decisions but can make the NHS re-check your case if mistakes have been made.

If you appeal and the decision is ruled in your favour, you can also claim funding retrospectively (backdated refunds) if funding should have been given before for past care, however these cases take time.

Key Takeaways - Making Sense of It All

Hopefully this guide has given you some further insight into what the NHS funds when it comes to care. Navigating care funding can be very overwhelming, but understanding the basics, and knowing what to ask for, helps.

• Full NHS funding is rare, and only those with very high medical needs qualify.
• Costs keep rising but the savings limits haven't changed, this means more families are forced to use personal funds to cover care.
• When looking for care, remember that they key to success is having good evidence, persistence, and understanding your rights.
• If you're unsure, organisations like Age UK or the NHS Website have clear, step-by-step guides.
• Even if you don't qualify for full NHS help there are still ways to reduce your costs.

More Resources

Finding care is not a quick job, there are so many details and caveats to take into account. That's why we think you might find it helpful to take a look at some of the resources we used for this guide:

• NHS continuing healthcare and NHS-funded nursing care - moneyhelper.org.uk