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The NHS is responsible for providing nursing care to people who need it, and to ensure fairness the Health and Social Care (HSC) contribute towards the cost of people in care homes that need nursing care.

On this page we tell you about:

1. Continuing healthcare
2. Who is responsible for the assessment of needs
3. HPSS payments for nursing care
4. Intermediate care

Health and social care professionals involved in your relative’s care will normally discuss whether to consider them for additional HSC funding in a care home. They would then be assessed automatically.

However, if such funding (either for continuing healthcare or HPSS payments for nursing care) hasn’t been mentioned, and you think your relative qualifies, ask one of the professionals involved in your relative’s care (nurse, discharge coordinator, a community nurse) or social services. 

NHS funded care should be considered:

  • at the end of a period of NHS intermediate care
  • as part of a care needs assessment
  • if your relative has a rapidly deteriorating condition.

Here we explain how you set about accessing the funding; for information about how the financial system works, see Financing care at home and Financing a care home.

Continuing healthcare

Continuing healthcare offers care, arranged and funded by the HSC, for individuals who have ongoing health and social care needs. Care might take place in an individual’s home or in a care home. It is most often available to people who have complex or unpredictable care needs due to disability, accident or illness.

Who is responsible for the assessment of needs?

HSC Trusts are responsible for ensuring that assessments of need are carried out for individuals, including those with continuing health care needs. 

These assessments will identify either a primary need for continuing healthcare, which is provided free of charge, or a primary need for social care. In the case of social care, the law requires the relevant HSC Trust to levy a means-tested charge whereby a person’s needs are met in a residential care or nursing home setting.

Eligibility for continuing healthcare is not condition-specific and therefore a particular diagnosis would not necessarily make an individual eligible for continuing healthcare. 

The distinction between health and social care is complex and requires a careful appraisal of each individual case. Within the integrated system in Northern Ireland, it is clinicians, together with other health and social care professionals, who are responsible for assessing the needs of the individual and for making decisions about appropriate long-term care.

HPSS payments for nursing care

Payments for nursing care were introduced in October 2002 on following a recommendation from a Royal Commission on Long Term Care. The purpose is to address the anomaly whereby nursing care is free in a person’s own home, a residential home and hospital, but nursing home residents (prior to October 2002) were required to pay for it.

Nursing home residents who have sufficient capital and income that they are assessed as able to meet the full cost of their care receive £100 ‘payments’ from the HSC (2017-18) to ensure they don't pay for the nursing element of their care.

Who can get HPSS payments?

In order to qualify for HPSS payments you must satisfy two conditions.

  • You must be responsible for the full costs of your nursing home care.
  • You must be assessed as needing nursing care. This will be revealed in your overall comprehensive assessment.

How your relative is assessed for HPSS payments

A person’s eligibility for nursing care will be considered as part of his or her overall comprehensive assessment. Part of this assessment will have been a nursing needs assessment, which will determine the extent to which a registered nurse should be involved in your relative’s care. You and your relative will be fully involved in this process and may request a personal copy of the assessment.

If your relative is in a nursing home and you think they should qualify for the HPSS payment for nursing care, ask the staff in the home.

What will your relative get?

Registered nursing care can include direct nursing tasks as well as the planning, supervision and monitoring of nursing and healthcare tasks to meet your relative’s needs.

The value of HPSS Payment for Nursing Care in 2017-18 is £100 per week. The nursing care contribution is paid directly to the care home by the HSC. If your relative pays their own care fees, this amount will be deducted from their bill. If they are council funded, the council will deduct this amount from the money it pays to the care home.

Intermediate care

Intermediate care is a range of integrated services to prevent unnecessary hospital admission, promote faster recovery from illness, support timely discharge and maximise independent living. 

If your relative has been in hospital, the hospital social work team arranges the care before your relative returns home. If your relative is at home, contact their local social services department, making sure the person taking the call knows it is an emergency

What will your relative get?

Your relative will get intermediate care regardless of their income and savings. The hospital and or social services will provide what they are assessed as needing, from physiotherapy to carers. The aim is to get your relative back on their feet and to ensure that they are as independent, mobile, confident and medically fit as possible.

For more information, see this leaflet produced by the Department of Health, Social Services and Public Safety.

More information

  • Self-funding care at home: find out how your relative might fund their care if he or she isn't eligible for HSC funding.
  • The HSC website will give you more information about health and social care in Northern Ireland.

Page last reviewed: June 2016
Next review due: April 2018