Do you have split NHS and Social Services Funding?

I read that it is quite common that people are being ofered support packages where the Nursing side is funded under Continuing Health Care and the 'Social Care' is funded under means tested Social Care provided by the Social Services.

This is not legal for two reasons.

First the Coughlin case where the Judge stated that where the is a primary health need all care must be provided by the NHS. This is now law because it is case law.

Secondly in the Continuing Health Care "Decision Support Tool" Glossary states:

“…where a person lives in their own home, it means that the NHS funds ALL the care that is required to meet their assessed health and social care needs.”

(Decision Support Tool Glossary, Page 50, last paragraph).

Split care is not lawful.

If you are in this situation you might consider an appeal citing these grounds to the Continuing Health Care Group. (NHS).

18 Replies

  • Another jolly good point Kevin 👏👏👏👏👏

  • I think I am becoming a little obsessed lol.


  • You are the resident CHC guru

  • I am still wearing L plates :)

    CHC has hit my 'injustice' funny bone...

    I am trying to organise a simple resource based on the 'Care to be Different' Website using them as a hyperlinked foundation.

    I'm probably mad as a hatter!

    But thanks. :)

  • Thanks Kevin, that's what we are getting, I'll message you soon for your very valued information x

  • Go ahead - I can draft a letter for you to edit.



  • I am just starting this process for my mother, am finding your posts helpful. Have downloaded the digital resource available from the Care to be Different website just ploughing my way through it looks like a mindfield

  • 'Mindfield' is a good description.

    There is a huge mount of information there and there are sub layers found only through document hyperlinks too.

    I have spent many hours there!

    I can point you to particular articles for the particular stages or contingencies if you like. No need to take it all on board.

    Just let me know.

    Best of luck


  • Oh, and by the way - if you win your case - which you should because they are breaking the law, then you can have it backdated to the date when they did the original checklist... another often ignored regulation.

    The NHS has to follow the law and regulations. So these things are not at the whim of a funding panel.


  • More great advise Kevin, thanks.


  • Hi, do you know if the nhs regulations for this is the same in Wales as in England?



  • Hi Pj

    Yes, I believe it is.

    I can dig up a good link on joint funding (do's n dont's) if it is any good to you.

  • Hi Kevin

    Any advice would be gratefully received. It seems that you are in information guru here from what I have been reading

    Thanks in advance


  • i agree wit h u al]l jill


  • Hi, Jill! It's morning here, and I just got up, checked the site and see you are here, too, so wanted to wish you a lovely weekend. Love, ec

  • Yes! Kevin is great!

  • Kevin, you kindly offered to advise me re: CHC. I have heard that we are going to be assessed for it again, meanwhile, B is going to be assessed by the Social Services as well. I would appreciate any help on these matters. Regards, Rx

    PS. Tried to do B's tax return, but the site is having problems and would not let me sign in! Hope you managed to do yours.

  • Oh, Robbo sorry to be so slow - Things have been on the rough side here. (Liz had a big step down).

    Technically split funding is illegal. Though there are more CHCs Soc Services doing it.

    Section 22 of the Care Act lays out the limits of the Social Services powers to offer services. That is they are not allowed to provide services beyond that point. CHC on the other hand is bound by the NHS Charter that all services and treatments must be delivered at the point of delivery and that must include everything needed to provide treatment and care.

    The standard thing to do here is to ask Social Services to specifically asses their ability to provide a service under Section 22. Few people can do this so you need to put that in writing to them ahead of the appointment.

    If Social Services decide that B's needs are beyond their limits then they are required to inform the CHC is pretty much bound to step in. I have seen this work a couple of times and it is a standard tack to force the CHCs hand a little.

    I assume you will be having another Decision Support Tool assessment from the CHC.

    Here are my notes on the matter:

    "A Decision Support Tool (DST) is completed as part of the second assessment stage. Remember that this is a supporting document, and the members of the multidisciplinary assessment team (MDT) do not have the power to make the actual funding decision; instead, they make a recommendation, and this is passed to a decision-making panel for the final decision. Have a look at paragraph 31 on pages 14-15 of the DST for the ‘scores’ your relative ideally needs to achieve, and look at page 21 onwards for information on how the assessment is scored and the kinds of things that are assessed.

    Be sure, also, to read the section about ‘nature, intensity, complexity and unpredictability’ on page 49; note also: the words ‘single condition’ under Complexity; the words ‘in combination or alone’ in the short paragraph tha follows the bullet points; and the words ‘expected to change’ in the last but one paragraph.

    Tool Available Here

    Scoring it yourself is and easy matter and sitting there with your score sheet and discussing the final agreed score is highly acceptable. Make notes of any disagreement in scores as this will make part of your appeal. Appeals are easy so no fretting there.

    I do hope this helps a little.

    I will keep a close eye out for any replies from you.

    Do feel free to ask about anything at all... I have loads of information distilled and ready to send back.

    We have until the end of Jan for Tax returns... Must do them tomorrow... or Tuesday ro... What the heck.


    Kevin x

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