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NHS Continuing Healthcare is available to people with dementia at any stage of the condition, but the threshold is based on care needs, not on how long a person has had dementia or what stage they have reached. In practice, most people with dementia who qualify for NHS Continuing Healthcare do so in the moderate to severe stages of the condition, when care needs have become complex enough to meet the primary health need test. Early and moderate stages In the earlier stages of dementia, a person's care needs may be primarily social: help with daily activities, prompting with medication, supervision for safety. These are important needs, but they typically sit within the scope of local authority social care rather than NHS Continuing Healthcare. As the condition progresses, the nature of the care required often shifts. Needs that were previously manageable with social care support begin to require a clinical response: skilled nursing input, complex medication management, management of behaviours that challenge, or dysphagia care. This shift is when an NHS Continuing Healthcare assessment becomes most relevant. Advanced stages In the advanced stages of dementia, many people have care needs that clearly meet the NHS Continuing Healthcare threshold across multiple domains simultaneously. These may include: Severe cognitive impairment with no meaningful retained capacity Double incontinence requiring full management Dysphagia requiring modified diet or specialist feeding management Behaviours that challenge requiring specialist clinical input High falls risk with multiple falls requiring clinical assessment Complex wound or pressure area management Unpredictable deterioration requiring constant monitoring What triggers an NHS Continuing Healthcare referral for someone with dementia? An NHS Continuing Healthcare assessment may be triggered at any of the following points: Hospital admission or discharge planning (hospitals have a duty to consider NHS Continuing Healthcare before discharge) Significant deterioration in condition (a GP or community nurse can make a referral) Transition to a care home (this is a common trigger for an NHS Continuing Healthcare assessment) Family or carer request: anyone can ask for an NHS Continuing Healthcare Checklist to be completed What should families do? If a family member has dementia and is receiving, or about to start receiving, significant levels of care, the question of NHS Continuing Healthcare eligibility should be raised. The sooner it is raised, the sooner funding can be established or, if it has not been established when it should have been, the sooner a retrospective claim can be prepared.

Understanding the cost of care, and what it means when NHS Continuing Healthcare funding is not in place, is one of the clearest ways to appreciate what is at stake in the NHS Continuing Healthcare process. What does a care home cost in England? Care home fees vary significantly by location, type of home, and level of care required. As a general guide for England: Residential care homes: approximately £800 to £1,200 per week (£40,000 to £62,000 per year) Nursing homes (with registered nursing input): approximately £1,000 to £1,500 per week (£52,000 to £78,000 per year) Specialist dementia nursing care: commonly £1,200 to £1,800 per week or more In London and the South East, fees are typically at the higher end or above these ranges. Who pays when NHS Continuing Healthcare is not in place? Without NHS Continuing Healthcare, care home fees are funded in one of two ways: Self-funding: The person (or their family) pays the full cost from their own savings, income, and assets, including the value of their property in many cases. Local authority funding: Once the person's assets fall below the upper capital limit (£23,250 in England at the time of writing), the local authority may contribute to care costs, but typically at a lower rate than the full fee, which can result in top-up fees that families are expected to pay. What is the means test threshold? In England, a person must fund their own care in full until their assets fall below £23,250. Below this level, the local authority takes over funding, but only at the local authority's assessed contribution rate, which may not cover the actual cost of the care home the person is in. What does NHS Continuing Healthcare change? If a person qualifies for NHS Continuing Healthcare, the NHS funds their care in full. There is no means test. The person's savings, property, and income are completely irrelevant. The funding continues for as long as eligibility is maintained. For a family that would otherwise be spending £60,000 to £100,000 per year on care home fees, NHS Continuing Healthcare represents a complete removal of that cost. The financial significance cannot be overstated. How can SG67 help? SG67 assists families in obtaining the NHS Continuing Healthcare funding their loved ones are entitled to, at the assessment stage, in appeals, and through retrospective claims for historic costs. A free initial consultation is available to discuss whether a particular situation is likely to meet the NHS Continuing Healthcare threshold.

Yes. NHS Continuing Healthcare can apply to people whose primary care needs arise from a mental health condition. However, NHS Continuing Healthcare for mental health needs is less straightforward than for physical health conditions, and there are specific frameworks that apply. When can mental health needs qualify for NHS Continuing Healthcare? NHS Continuing Healthcare is available to any adult whose primary need for care is health-related, regardless of whether that health need is physical or mental. A person with a severe and enduring mental health condition can qualify for NHS Continuing Healthcare if the nature, intensity, complexity, and unpredictability of their needs meet the threshold. In practice, this tends to apply to people with: Severe and treatment-resistant mental illness (such as schizophrenia or bipolar disorder with significant and persistent impact on functioning) Complex needs that require ongoing specialist clinical input and cannot be managed safely through standard community mental health services Behaviours that present a significant risk to themselves or others and require intensive management Mental health conditions combined with physical health needs that together create a level of complexity requiring clinical oversight What about Section 117 aftercare? Section 117 of the Mental Health Act 1983 creates a separate legal duty for the NHS and local authorities to provide aftercare for people who have been detained under certain sections of the Act and then discharged from hospital. Section 117 aftercare is free at the point of use and cannot be means-tested. It covers health and social care services designed to meet the needs arising from the person's mental disorder and to reduce the risk of readmission. Importantly, Section 117 and NHS Continuing Healthcare are separate frameworks. A person receiving Section 117 aftercare is not automatically assessed for NHS Continuing Healthcare, and vice versa. However, a person's eligibility for one should not prevent them from being assessed under the other. How is mental health NHS Continuing Healthcare assessed differently? There is a separate Decision Support Tool for mental health that can be used for people whose primary needs are mental health-related. This tool uses a different set of care domains that are more appropriate to the kinds of care needs that arise from mental health conditions. In practice, the mental health NHS Continuing Healthcare pathway is used less frequently than it should be. Families and professionals are often less aware of it, and mental health ICB teams may not routinely refer people for assessment. What should families do? If a family member has severe, complex mental health needs that require significant and ongoing clinical input, it is worth asking whether an NHS Continuing Healthcare assessment has been considered. A nurse advocate can advise on whether the circumstances are likely to meet the threshold and can help navigate both the NHS Continuing Healthcare and Section 117 frameworks.

NHS Continuing Healthcare eligibility is not decided on the basis of diagnosis. The NHS does not have a list of qualifying conditions. A person is not entitled to NHS Continuing Healthcare because they have a particular disease, and they are not excluded because their condition is not on a specified list. What matters is the nature, intensity, complexity, and unpredictability of the care that the condition creates. However, in practice, certain conditions commonly produce the level of care need that meets the NHS Continuing Healthcare threshold. Conditions that frequently give rise to NHS Continuing Healthcare eligibility Dementia Advanced dementia (including Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia) is one of the most common conditions in people who qualify for NHS Continuing Healthcare. Needs related to cognition, behaviour, nutrition, communication, and continence frequently combine to establish a primary health need. Parkinson's disease In the later stages, Parkinson's disease can produce highly complex care needs, including dysphagia, falls risk, severe mobility problems, communication difficulties, and cognitive impairment. The fluctuating and unpredictable nature of the condition is particularly relevant to the NHS Continuing Healthcare criteria. Motor neurone disease (MND) MND is a progressive, life-limiting condition that affects the nerves controlling movement, speech, swallowing, and breathing. The level of clinical need in the later stages almost always meets the NHS Continuing Healthcare threshold. The Fast Track pathway is frequently used in MND cases. Multiple sclerosis (MS) People with advanced or progressive MS may have significant needs across multiple DST domains, including mobility, continence, fatigue management, and cognitive function. Eligibility depends on the severity and complexity of need rather than the diagnosis itself. Stroke Severe stroke can leave a person with complex, ongoing care needs, including communication impairment, dysphagia, hemiplegia, and cognitive difficulties. Where these needs require clinical management and oversight, NHS Continuing Healthcare may apply. Cancer People with advanced cancer who are receiving active symptom management, palliative care, or end-of-life care frequently qualify for NHS Continuing Healthcare, often through the Fast Track pathway. Pain management, symptom control, and the unpredictable nature of deterioration are key considerations. Acquired brain injury Traumatic or acquired brain injury can leave a person with profound, complex care needs across many domains, including behaviour, cognition, communication, mobility, and psychological wellbeing. NHS Continuing Healthcare eligibility is common in these cases. Mental health conditions In some cases, a person with severe and enduring mental health conditions may meet the NHS Continuing Healthcare threshold, particularly where their needs are intense, complex, and require a level of clinical oversight that goes beyond what standard community or social care can provide.

Yes, and this is one of the most important and least widely known aspects of the NHS Continuing Healthcare system. Retrospective NHS Continuing Healthcare claims can be made after a person has passed away. For families who funded care privately, often for years, the amounts that can be reclaimed are significant. What is a retrospective NHS Continuing Healthcare claim? A retrospective NHS Continuing Healthcare claim is a formal application to the NHS to recover care costs that should have been funded by NHS Continuing Healthcare during a person's lifetime. The claim is made on the basis that the person's needs during that period met the NHS Continuing Healthcare eligibility threshold, but that they were either never assessed, assessed incorrectly, or wrongly refused. Who can make a retrospective claim? A retrospective claim can be made by the person's estate, typically by the next of kin, executor, or power of attorney representative. The claim is pursued on behalf of the person (or their estate), not the individual making it. How far back can a claim go? Retrospective claims can typically go back up to 14 years. The timeframe depends on the circumstances, the availability of records, and the ICB responsible for the relevant period of care. The further back the claim goes, the more important it is to gather medical and care records from the relevant period. These records form the basis of the assessment of whether needs at that time would have met the NHS Continuing Healthcare threshold. What is the claim process? A retrospective claim involves a review of the person's clinical and care records from the period in question. An assessor (usually from the ICB, overseen by NHS England) reviews the records and applies the NHS Continuing Healthcare eligibility framework retrospectively. The process can be complex and time-consuming. Having an experienced nurse advocate manage the claim significantly improves the prospects of success, because the clinical evidence is presented within the correct framework, and any attempt to under-score needs can be challenged at each stage. Does SG67 handle retrospective claims? Yes. SG67 handles retrospective NHS Continuing Healthcare claims on a no-win, no-fee basis. There is no upfront cost, and no fee if the claim is unsuccessful. Families who are not sure whether a claim is worth pursuing can discuss the circumstances in a free initial consultation.

For people approaching end of life, NHS Continuing Healthcare can be accessed through an urgent pathway that bypasses the standard two-stage assessment process. Understanding how this works, and how to access it quickly, can make a critical difference for families in this situation. What is the Fast Track NHS Continuing Healthcare pathway? Fast Track NHS Continuing Healthcare is designed for situations where a person is rapidly deteriorating or has a condition that is expected to cause death in the near future. A clinician (typically a GP, consultant, or specialist nurse) completes a Fast Track Pathway Tool. If the application is approved, NHS Continuing Healthcare funding can be put in place within days rather than weeks. This means that where a person has urgent care needs, including the need to move home from hospital or to increase care provision, those needs can be met by the NHS without waiting for the standard assessment process. Who can apply for Fast Track NHS Continuing Healthcare? Any registered clinician who is treating the person can initiate a Fast Track application. This includes GPs, hospital consultants, palliative care nurses, and specialist nurses. The Fast Track Pathway Tool requires the clinician to confirm that the person has a rapidly deteriorating condition and that a need for palliative or end-of-life care exists. Families can request that a clinician considers initiating a Fast Track application. SG67 can advise on how to approach this conversation and can act urgently if an application is needed. Can Fast Track NHS Continuing Healthcare be refused? Yes, and it is refused more often than it should be. Fast Track applications can be declined by the ICB, delayed without proper justification, or have funding withdrawn after it has been put in place. All of these situations can be challenged. SG67 acts urgently in Fast Track cases. If an application has been refused, delayed, or has not yet been initiated in a situation where it is clearly needed, contact us as a priority. What care does Fast Track NHS Continuing Healthcare cover? Fast Track NHS Continuing Healthcare covers the full cost of whatever care is needed to meet the person's health needs at end of life. This may include: Nursing home or residential care home placement 24-hour care at home District nursing visits and specialist nursing input Palliative care support Equipment and aids required for care at home Does NHS Continuing Healthcare funding end when the person dies? NHS Continuing Healthcare funding ceases when the person passes away. However, a retrospective claim for historic NHS Continuing Healthcare funding can be made on behalf of the estate, including for care costs paid privately before the person died. SG67 handles retrospective claims and can advise whether a claim is worth pursuing.

One of the most important and most misunderstood aspects of NHS Continuing Healthcare is that it covers the full cost of care home fees. Not a contribution. Not the nursing element only. The full cost. For families paying residential or nursing home fees privately, this can represent a saving of £50,000 to £100,000 or more per year. Does NHS Continuing Healthcare cover residential care home fees? Yes. If a person qualifies for NHS Continuing Healthcare, the NHS funds their care in full, regardless of whether they are living in a residential care home, a nursing home, or at home with community care. The person's savings, property, and income are completely irrelevant. This is fundamentally different from local authority social care funding, which is means-tested. NHS Continuing Healthcare is a health entitlement. It exists because the person's primary need is health-related, not because they cannot afford to pay. What is the difference between NHS Continuing Healthcare and Funded Nursing Care (FNC)? Funded Nursing Care (FNC) is a lower level of NHS contribution paid directly to a nursing home for people who do not meet the full NHS Continuing Healthcare threshold but who require registered nursing input as part of their care. The current FNC rate is approximately £235 per week. FNC is not the same as NHS Continuing Healthcare. Under FNC, the person (or local authority) still pays the remainder of the care home fees. Under NHS Continuing Healthcare, the NHS pays everything. Can a person be assessed for NHS Continuing Healthcare while already in a care home? Yes. An NHS Continuing Healthcare assessment can be requested at any point: before, during, or after a care home placement. If a person is already paying for care and there is reason to believe they may meet the NHS Continuing Healthcare threshold, a referral for a Checklist can be made. Integrated Care Boards are responsible for NHS Continuing Healthcare assessments in the relevant area. A request can be made directly to the ICB, or through a GP or community nurse. What if care home fees have already been paid privately? If a person was paying privately for care home fees during a period when they should have qualified for NHS Continuing Healthcare, a retrospective claim can be made to recover those costs. This applies even if the person has since passed away. Retrospective claims can go back up to 14 years in some circumstances. Can the NHS direct which care home the person lives in? In some cases, the ICB may have preferred providers or standard rates. However, under a Personal Health Budget arrangement, the person (or their representative) can choose their own care home, provided the care meets their assessed needs and is within a reasonable cost envelope. SG67 can advise on Personal Health Budgets and how to use them effectively.

Many NHS Continuing Healthcare refusals and unsuccessful assessments share the same patterns. Understanding the most common mistakes, and how to avoid them, can make a significant difference to the outcome of an NHS Continuing Healthcare application. 1. Assuming the system will identify eligibility without advocacy The NHS Continuing Healthcare assessment is not a passive process that automatically identifies every eligible person. It relies on evidence being presented effectively within a specific clinical framework. Families who assume the assessors will simply see the level of need, without any preparation or active contribution, frequently find that needs are underscored. 2. Accepting the outcome of the Checklist without question Many families are screened out at the NHS Continuing Healthcare Checklist stage and never reach the full DST assessment. The Checklist is not the final word on eligibility. It is a screening tool, and incorrect outcomes at this stage can and should be challenged. 3. Not attending the assessment Family members have the right to attend both the Checklist and the DST assessment. Choosing not to attend, or not being told this right exists, means the assessors will have only clinical records to work from. Those records often do not reflect the full picture of day-to-day care needs, particularly unpredictable or difficult episodes. 4. Describing needs in general terms rather than specific ones Statements such as "she needs a lot of care" or "he can be difficult to manage" do not score well in a structured assessment. The DST requires specific, evidenced descriptions: how often, how severe, what clinical intervention is required, and what happens if that intervention is not provided. Preparing specific examples before the assessment is essential. 5. Underestimating needs out of habit or politeness Families who have provided or managed care for months or years often understate what they actually do. Care routines that have become normalised, such as turning and repositioning every two hours, managing complex medication regimes, and responding to seizures or episodes of acute distress, may not be described at all unless directly prompted. Everything should be on the table. 6. Not gathering evidence of unpredictability Unpredictability is one of the four criteria for establishing a primary health need, and one of the most commonly underscored. If a person's condition fluctuates significantly (falls, acute episodes, sudden deterioration) that pattern needs to be evidenced. A carer log or diary showing the frequency and nature of difficult episodes is far more persuasive than a verbal description. 7. Accepting a refusal without appealing A refusal is not the end of the process. Many NHS Continuing Healthcare decisions are overturned on appeal, particularly where domains have been under-scored, where clinical evidence has not been considered properly, or where the unpredictability of needs has not been factored in. If a refusal has been received, it is worth asking an experienced nurse advocate to review the decision.

Understanding the questions an NHS Continuing Healthcare assessor is likely to ask is one of the most effective ways a family can prepare for the assessment process. The questions follow the structure of the Decision Support Tool (DST), a 12-domain framework that assessors use to evaluate whether a primary health need exists. The 12 assessment domains and what assessors ask For each domain, the assessor will ask questions designed to establish the level of need: None, Low, Moderate, High, or Severe/Priority. The following gives families a guide to what to expect. Behaviour Questions here explore whether the person has behaviours that challenge, including aggression, agitation, self-harm, wandering, or resistance to care. Assessors will ask how frequently these occur, how severe they are, and whether they place the person or others at risk. Cognition This covers the person's ability to understand, remember, make decisions, and process information. Assessors may ask about memory, orientation, capacity to consent, and whether cognitive impairment creates safety risks. Psychological and emotional needs Questions here cover anxiety, depression, distress, and emotional wellbeing. Assessors will ask whether psychological needs require professional intervention and whether they interact with other care needs. Communication Assessors will ask about the person's ability to express needs, understand others, and seek help. This includes verbal and non-verbal communication, and whether communication difficulties create risk. Mobility Questions cover the person's ability to move safely, including transfers, falls risk, and whether moving requires specialist equipment or more than one carer. Nutrition, food, and drink This domain covers swallowing difficulties (dysphagia), feeding assistance, unintentional weight loss, and whether nutrition management requires clinical oversight such as PEG feeding or thickened fluids. Continence Assessors ask about continence management, frequency of episodes, skin integrity related to incontinence, and whether management requires skilled nursing care. Skin integrity Questions here cover wounds, pressure areas, fragile skin, and any skin conditions requiring clinical management. The frequency and complexity of dressing changes is particularly relevant. Breathing This covers any respiratory conditions, oxygen dependency, use of suction or ventilation, and whether breathing difficulties require clinical management. Drug therapies and symptom control Assessors will ask about medication complexity, symptom management, whether the administration of drugs requires clinical oversight, and whether symptoms are difficult to control or unpredictable. Altered states of consciousness This includes seizures, episodes of unconsciousness or near-unconsciousness, and any conditions causing fluctuating levels of awareness. Assessors will ask about frequency, severity, and risk. What to keep in mind Assessors visit once. If the person is having a relatively settled day, the needs they observe may not reflect the typical reality. Families should be prepared to give specific examples: dates, incidents, frequency, rather than general descriptions. Evidence and detail matter far more than a general impression.

An NHS Continuing Healthcare assessment visit can feel overwhelming, particularly if a family is navigating it without any specialist guidance. The key is to understand what the assessors are looking for and to prepare accordingly. What happens during the assessment visit? The NHS Continuing Healthcare assessment is a structured clinical process using the Decision Support Tool (DST). Assessors (typically a nurse and a social worker representing the NHS and local authority respectively) will ask questions about the person's care needs across 12 domains: behaviour, cognition, psychological and emotional needs, communication, mobility, nutrition, continence, skin, breathing, symptom control, medication, and altered states of consciousness. The meeting can take place in a care home, at the person's home, or in a hospital or community setting. The person being assessed may or may not be present, depending on their capacity. Who can attend? Family members and representatives have the right to attend the assessment meeting. This right is not always communicated by the ICB, but it exists. A nurse advocate can also attend, and in most cases, expert representation at this meeting makes a material difference to the outcome. What to prepare in advance Gather all relevant documents before the visit. Do not rely on the assessors to have reviewed clinical records in detail. Prepare a brief written summary of the person's care needs, structured around the 12 DST domains. This gives the assessors a clear reference point and ensures nothing is missed. If the person's needs are variable or unpredictable, compile a log of typical difficult periods (incidents, escalations, emergency interventions) to demonstrate the pattern. Speak to care staff, district nurses, or the GP in advance. A brief note or letter from a clinician who knows the person well can support the assessment significantly. What not to do during the assessment Do not allow the assessment to focus only on a good day or a settled period. Assessors visit once, and the picture they observe on that day may not reflect the full reality of care needs. The responsibility falls on the family (or their representative) to describe the full picture, including the difficult times. Do not minimise care needs out of politeness or habit. Families who have lived with a care situation for a long time sometimes understate how much care is actually being delivered. Be specific, be accurate, and be complete. What happens after the assessment visit? Following the DST assessment, the multidisciplinary team (MDT) meets to review the scores and make a recommendation. The Integrated Care Board (ICB) then makes the final funding decision. The family should be notified in writing. If the decision is a refusal, the reasons must be provided, and the decision can be challenged.

Preparation is one of the most powerful things a family can do before an NHS Continuing Healthcare assessment. Having the right documents and evidence ready, and knowing how to present them within the assessment framework, can significantly improve the outcome. Why does documentation matter? The NHS Continuing Healthcare assessment is based on a structured clinical framework. The assessors score the person's needs across 12 domains using the Decision Support Tool (DST). Each score must be justified by evidence. If the evidence supporting a higher score is not presented at the assessment, that domain is likely to be scored lower than it should be. The NHS assessors rely on clinical records. But clinical records do not always capture the full picture, particularly the day-to-day reality of care needs at home, the frequency of incidents, or the unpredictability of the person's condition. Key documents to gather before the assessment GP records and letters: Evidence of diagnosis, medication, and clinical input. A letter from the GP specifically addressing care needs and complexity is particularly useful. Hospital discharge summaries: These set out the person's condition and care requirements at the point of leaving hospital. Community nursing or district nurse records: Log of clinical visits, wound care, catheter management, medication administration, or other nursing interventions. Care home records (if applicable): Daily care logs, incident reports, and care plan documents. Carer logs or diary: If the person is cared for at home, a written record of care interventions across a typical 24-hour period is extremely valuable. This should capture frequency, complexity, and any episodes of distress or unpredictability. Specialist assessments: Reports from physiotherapists, occupational therapists, speech and language therapists, or specialist nurses. Medication records: Particularly important where the medication regime is complex, requires skilled administration, or involves significant clinical oversight. What about evidence of unpredictability? Unpredictability is one of the four criteria used to determine a primary health need, and one of the most commonly underscored. Evidence of unpredictability includes incident logs (falls, episodes of severe agitation, sudden deterioration), records of emergency GP or hospital callouts, notes from carers about difficult or unpredictable periods, and any clinical correspondence that refers to instability in the person's condition. Can a family member present evidence at the assessment? Yes. Family members have the right to attend both the NHS Continuing Healthcare Checklist and DST assessment meetings, and to contribute information about the person's care needs. A nurse advocate can attend alongside the family, or in their place, to ensure the evidence is presented effectively within the clinical framework that assessors use.

Dementia is one of the most common conditions among people who qualify for NHS Continuing Healthcare funding. However, many families are told, incorrectly, that dementia alone does not qualify a person for NHS Continuing Healthcare, or that NHS Continuing Healthcare does not cover care home fees. Both of these statements are wrong. Here is what families need to know. Does dementia automatically qualify someone for NHS Continuing Healthcare? No. NHS Continuing Healthcare eligibility is not based on diagnosis. A person is not automatically entitled to NHS Continuing Healthcare simply because they have dementia, and they are not automatically excluded either. Eligibility is based entirely on the nature, intensity, complexity, and unpredictability of the person's care needs, not on the label attached to their condition. However, people with advanced dementia very commonly have needs that meet the NHS Continuing Healthcare threshold. This includes needs related to cognition, behaviour, nutrition, communication, and continence, across several of the 12 DST domains simultaneously. What dementia-related needs are considered in an NHS Continuing Healthcare assessment? The following are among the most commonly assessed needs for people with dementia: Cognition: Severe disorientation, inability to make decisions, lack of capacity to manage daily activities Behaviour: Agitation, aggression, wandering, behaviours that challenge and require a clinical response Nutrition: Dysphagia (difficulty swallowing), refusal to eat, significant weight loss Communication: Inability to express needs, to understand others, or to seek help when required Continence: Double incontinence requiring full management Psychological and emotional needs: Severe distress, anxiety, depression alongside cognitive decline Does NHS Continuing Healthcare cover care home fees? Yes. If a person qualifies for NHS Continuing Healthcare, the NHS funds their care in full, regardless of where that care is delivered. This includes residential care homes and nursing homes. This is one of the most significant financial distinctions in the care system. Without NHS Continuing Healthcare, a family in England may be paying £50,000 to £100,000 or more per year in care home fees once savings fall below the threshold for local authority support. NHS Continuing Healthcare removes that cost entirely. Why are so many dementia patients incorrectly refused? Dementia is a progressive condition and needs fluctuate. On a good day, a person with dementia may appear more settled than on a difficult day. Assessors who visit once, or who rely on care records that do not capture the full picture, may underestimate the true level of need. Families and carers who live with the reality of the person's condition every day are often the best source of evidence. Getting that evidence presented correctly in the assessment is critical. Can NHS Continuing Healthcare be claimed retrospectively for someone with dementia? Yes. If a person with dementia was paying privately for care during a period when they should have been receiving NHS Continuing Healthcare, a retrospective claim can be made to recover those costs, even after the person has passed away. Retrospective claims can go back up to 14 years in some circumstances. SG67 handles retrospective claims on a no-win no-fee basis.