Family awarded £160,000 after NHS should have covered care home fees

A family has recovered more than £160,000 after discovering an elderly relative had wrongly paid private care home fees that should have been funded by the NHS.

The woman, known only as Ms B to protect her family's privacy, spent the final five years of her life in a residential care home in Marlborough, Wiltshire. During that time, her savings were exhausted, and her family was forced to sell her home to repay a council loan used to cover care costs.

Following her death in 2020 at the age of 90, relatives learned she may have been entitled to NHS Continuing Healthcare (CHC) funding a scheme that pays the full cost of care for adults whose primary needs are health-related rather than social care.

The family sought legal advice from Emerald Law Solicitors in 2022. After reviewing the case, the firm concluded that Ms B had qualified for NHS Continuing Healthcare for two years, six months and 27 days.

As a result, the Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board agreed to settle the case, awarding the family £160,860.16.

Phil Turner, an NHS Continuing Healthcare specialist at Emerald Law Solicitors, said many families remain unaware that they could qualify for the scheme.

"NHS Continuing Healthcare can make a life-changing difference, but many families do not realise it may apply to them," he said.

Unlike local authority-funded care, NHS Continuing Healthcare is not means-tested, meaning eligible individuals can have the full cost of their care paid by the NHS regardless of their financial circumstances.

One of Ms B's nieces welcomed the outcome, saying the settlement meant the family had finally received "the inheritance my aunt intended for us."

Oonagh Murphy, Managing Director at Emerald Law Solicitors, said the family had faced both emotional and financial hardship.

"They should not also have had to face the financial devastation of using savings, property and debt to pay for care that should have been funded by the NHS," she said.

The case has also highlighted wider concerns about public awareness of NHS Continuing Healthcare.

Age UK Wiltshire says many families only learn about the scheme after they have already used their own money to pay for care. The charity encourages anyone unsure about eligibility to seek independent advice and request an assessment as early as possible.

A spokesperson for the Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board said it does not comment on individual cases but confirmed that concerns over eligibility decisions are handled through an established review process in line with national guidance.