Surely the NHS will pay?

The good news is that if the NHS arranges a place in a care home under a contractual arrangement, you remain an NHS patient and therefore do not have to pay (although state benefits may be reduced or withdrawn).

If your need is primarily health care, you should fall within the local criteria to be fully funded by the NHS. Here theory and the real world part company. There is never enough money in the system. Although it is said that about 10% of places are funded by the NHS, unless you are discharged to a hospice to die within a month or two, don’t count on getting NHS funding.

The NHS uses a decision tool that is very complex, which HM Government says is designed to ensure correct decisions and consistency no matter where you live, but the effect is to disqualify all but the very worst cases from getting NHS funding. This can lead to the hospital saying a patient is bed-blocking and putting immense pressure on relatives to find a Nursing Home, because the patient’s needs on discharge can only be met by a Nursing Home, and the other arm of the NHS refusing to fund, saying the nursing is incidental to the provision of accommodation and “of a nature social services are expected to provide”. The State may pay a Registered Nursing Care Contribution, but this will be a fraction of the actual weekly cost of the home.

A patient who has been “sectioned” under the Mental Health Act is in a special position. The State provides after-care services free of charge, until the patient no longer needs such services.

So, in practice, if you have not planned to have “the wherewithal” to pay for the Home you want, you are likely to find yourself in the means-tested regime run by the Social Services Department of the Local Authority if you need to go into a Home.

Please remember the Rules in Scotland, Northern Ireland and Wales are different, so this website deals only with the situation in England.