Eligibility for healthcare funding is determined by whether or not a person has a primary health need and the severity and nature of this health need. If a person has a primary health need and their overall health and social care needs cannot be lawfully met by the local authority, then the NHS has a responsibility to meet these needs, whether that is in primary care/acute setting or through a private care provider, either as home care or in a care home.
If you are living with a condition that impacts your health, for example a physical disability or a life-limiting condition or need nurse-led care following an illness or accident, then it is likely that once you have completed the continuing healthcare checklist that you will be eligible for NHS continuing healthcare funding.
It is not surprising that many people find the concept of a ‘primary healthcare need’ confusing. You may assume that a person who is living with dementia and unable to live independently, is unable to mobilise, is incontinent, requires medications administration and cannot wash or dress, would be entitled to healthcare funding. This is not necessarily the case as needs are considered to be social care or personal care needs, which can be met through social care funding. Clearly, the nature and intensity of the dementia can present other primary health care needs, which may result in being eligible for healthcare funding following CHC screening.