NHS-Funded Nursing Care – A tax-free, non-means tested benefit
Patients in a Nursing Home (or a home that is registered to provide nursing care) can claim NHS-Funded Nursing Care (FNC) to help towards the nursing element of their care. It is paid at two flat rates, standard rate or higher rate, depending on the amount of nursing care needed.
FNC is set at a standard weekly rate per person rising from £235.88 to £254.06 per week from 1 April 2025.
The funding is paid by the NHS directly to the nursing home.
FNC cannot be claimed at your own home or in a residential care home.
FNC is a tax-free, non-means tested benefit.
FNC is considered at the same time as you are assessed for NHS Continuing Health Care Funding (CHC). If you been found not eligible for CHC, but you need care from a registered nurse, the NHS will automatically decide if FNC is appropriate and, if so, which of the two rates should be paid.
So, there are two different types of funding, CHC and FNC:
- NHS–Continuing Healthcare (CHC) – is full funding covering care at home or in a care home, hospice or other care facility. It covers 100% of care fees, including social care and the cost of accommodation – i.e. everything.
- NHS-Funded Nursing Care (FNC) – is a weekly benefit paid by the local NHS Integrated Care Board (ICB) for people who need some nursing care, but who are not eligible for full CHC Funding. It covers the services provided by a registered nurse, including planning, supervising and monitoring nursing and healthcare tasks, as well as the physical nursing care.
When and how is FNC assessed?
The only way anyone can decide whether your relative should receive FNC is if they first have a free assessment for NHS Continuing Healthcare.
If, having been assessed for CHC, they are found not eligible, the NHS Nurse Assessor will automatically consider if FNC is appropriate.
Remember: Paragraph 274 of the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care states that you MUST be assessed for NHS-Continuing Healthcare first. Only after that should your relative be assessed for FNC – not the other way round:
Paragraph 274 – National Framework – ‘Eligibility for NHS Continuing Healthcare must be considered, and a decision made and recorded (either at the Checklist or DST stage), prior to any decision on eligibility for NHS-funded Nursing Care. For clarity, people who do not require a full assessment of eligibility for NHS Continuing Healthcare can still be eligible for NHS-funded Nursing Care. If an individual has a negative Checklist this simply means that they are not eligible for, and do not require, assessment of eligibility for NHS Continuing Healthcare at this point in time. However, they may require registered nursing in a care home with nursing’.
Our Tip: Don’t make the mistake of being pushed into talking about FNC unless and until your relative has first had their CHC assessment and been turned down!
When isn’t FNC applicable?
FNC is not paid if your relative has to go into hospital. (They may still have to pay for their care home placement in the meantime, though.)
FNC is to pay for the time of a registered nurse. Therefore, if your relative is not receiving care from a registered nurse, FNC will not be applicable.
You cannot get FNC in your own home or in a residential care home. It can only be paid in a nursing home that is registered to provide nursing care.
How is FNC paid?
As above, FNC is a weekly sum paid directly by the NHS Integrated Care Board to the nursing care home (unless there is an agreement in place for this to be paid via a third party (e.g. a local authority). It is a contribution to ‘reimburse’ the cost of any nursing care provided by the registered nurse.
Depending on how the care home contract is written, it may lower the overall care fees paid by the individual. So, if you’re paying for your own care, and your fees are calculated to include all nursing care, your care fees should reduce once the NHS starts paying FNC. However, many people see no difference at all, even though the care home is obliged to show how FNC reduces the care fees. Transparency is paramount. Yet, some nursing homes may see this as a ‘windfall’.
If the contract is silent (i.e. it doesn’t mention how FNC payments are to be handled), they may well pocket the FNC payment received from the NHS, and in addition, still charge your relative full rates! It’s always worth questioning this with the care home and, of course, checking what the contract states prior to accepting the placement.
Many families are unaware that their relative is in receipt of FNC, or if they are, don’t really understand what it is, and so don’t challenge what happens to the payments.
Our Tips:
- Look at the contract and the monthly invoices to see whether FNC is mentioned.
- Check to see how they have accounted for FNC and whether credit has been given for this weekly payment to reduce the fees payable.
- If necessary, speak to the Continuing Healthcare Department at your local NHS Integrated Care Board.
- Also consider paragraph 280 of the National Framework, set out below:
- Paragraph 280: ‘The Care home provider should set an overall fee level for the provision of care and accommodation. This should include any registered nursing care provided by them. Where an ICB assesses that the resident’s needs require the input of a registered nurse they will pay the NHS-funded Nursing Care payment (at the nationally agreed rate) direct to the care home, unless there is an agreement in place for this to be paid via a third party (e.g. a local authority). The balance of the fee will then be paid by the individual, their representative or the local authority unless other contracting arrangements have been agreed’.
How Long Does FNC last?
According to paragraph 277 of the NHS National Framework, individuals who are in receipt of NHS-funded Nursing Care are entitled to continue to receive it whilst they are alive until it is no longer appropriate. For example:
(a) if your relative no longer lives in a care home (or one that provides registered nursing care); or
(b) lives in a care home but does not now need any level of nursing care from a registered nurse; or
(c) your relative’s healthcare needs have changed and they have become entitled to fully funded free NHS Continuing Healthcare instead.
Tax and benefits
FNC is a tax-free benefit and is not means-tested.
As above, it can be withdrawn if the NHS decides you no longer need it.
FNC does not affect your entitlement to Attendance Allowance. However, it’s always best to double check your payments, as it has been known for government employees to confuse FNC with NHS Continuing Healthcare and, as a result, stop paying Attendance Allowance!
For more information, read our blog from the archives to give an outline (Nb: please be aware that some of the rates may have since changed):
Is your relative claiming their full entitlement to benefits?
What should you do?
If your relative has nursing needs but is not receiving either FNC or CHC:
- Make sure they are assessed for NHS Continuing Healthcare funding (full funding).
- If they’ve already been assessed for full funding but turned down, ask the NHS Continuing Care Team why FNC has not been awarded.
- Ask the care home to give you a breakdown of the nursing element of care in your relative’s care plan to support your enquiry.
- If there is a change in care needs after FNC or CHC has been assessed, make sure to ask for a new assessment for CHC. This could result in standard or higher rate FNC or CHC becoming payable.
And of course, if you believe the outcome of the NHS Continuing Healthcare assessment was wrong, you must appeal! Visit our website for lots of helpful blogs on appeals.
For further reading about FNC, look at paragraphs 270 – 286 of the National Framework: https://assets.publishing.service.gov.uk/media/64b0f7cdc033c100108062f9/National-Framework-for-NHS-Continuing-Healthcare-and-NHS-funded-Nursing-Care_July-2022-revised_corrected-July-2023.pdf
Dear CTBD readers,
Don’t be hoodwinked by this stream of funding! This paltry weekly amount is insignificant when most residents are paying in excess of a thousand pounds a week! I clearly remember my mum saying how kind the NHS were, in contributing to my late father’s fees! She didn’t understand CHC. My argument is that if your loved one has been specially placed in a nursing home by CHC/CCG, then there is an acknowledgement that their needs are significant and that they require nursing care 24/7, as did my father. For me, it was a case of proving through the K.I.s that my father’s needs were indeed, intense, complex and unpredictable. I believe, anyone who has been awarded this funding should appeal the process and strive for full funding.
Dear CTBD
Can a care home keep FNC to compensate increases in their fees as I believe this is what’s happening in my mums case resulting in her paying more than she should be if FNC is deducted from the fees charged at present
I have been in dispute with this for months going round in circles and being fobbed of being told at one point she wasn’t receiving the funding
Mum was receiving CHC funding until Feb then it was taken away but was told she would receive FNC
If you require 24/7 care in a nursing home, how can you separate care from a registered nurse, when the care being given is being delegated and overseen by a nurse? Surely this is still classed as a nursing need, otherwise you could be in a residential home and just getting visits from the district nurse. This is a crafty way of making you pay for part of care as funded nursing care only happens in a nursing home.
In my mother’s case FNC was awarded some three weeks before her CHC Assessment. I pointed out to the CCG that this completely ignored all the NHS instructions that FNC can only be awarded following an unsuccessful application for CHC.
The CCG replied that they had implemented this locally agreed (reverse) procedure as a direct result of complaints about the length of time it was taking to set up FNC payments while waiting for the outcome of CHC assessments. I replied saying that this was directly incompatible with the legislation. I then asked the CCG to provide details of the approval sought between them and The National Framework which allowed them to ignore the legislation.
The astonishing CCG reply was that the National Framework was only guidance and therefore did not breach any legislation.
This is now part of an appeal about process to the Independent Review Panel.
My father was granted FNC by the local CCG after his latest assessment for CHC was not approved. The decision in July awarded funding effective from Nov last year. The care home have confirmed that they will deduct the FNC payments from his care bill so we have been fortunate that they are not just absorbing FNC as an additional payment. It depends on the contract you sign at the start of residency and dad was down for full on support so they had technically already indicated he needed nursing care and hence why they are going to deduct the payments from his care bill going forward.
Please be aware though that even if you are approved for FNC it takes a long time to come through! Payment still not taken effect for dad although I’m hopeful that the latest payment run will include it so he will initially get a big lump sum to cover the period from Nov last year up until now.
This funding is a joke. My experience – As soon as it was awarded the care home put the fees up to cover their costs of ‘increased nursing’ which they said were now required. (Which were no different to the care given before the funding was awarded)
My daughter got the social services to give my brother an assessment but he cancelled it because he thought they were going to make him sell his house he has Prostrate Cancer very bad and has to have. Catheter on which keeps coming off .A nurse has to go to the home and flush it out twice a week he has Arthritis in his legs and elbows and cannot walk as he keeps falling over . He has been paying Care fees now at full rate because the care home just kept giving him a bill of £2600 a month now £3000 a month and has now ran out of money My daughter has now got the social worker involved as she is going to try to get him an assessment but there is no visiting at he moment because of the virus How do we go about money wise has he has already paid £46000 and owes about another 18000 because he cannot get to the bank because of the virus and the social worker said he shouldn’t have paid a penny before he had an assessment and it’s the care homes fault for not informing the social worker he is 92 years old and the are all confined to their rooms .
My husband has advanced Parkinson’s
And had a nursing assessment for permanent i home nursing care.
He’s completely dependent on others for every need. I’m struggling to do the basics for him like feeding meds ect
As I have severe heart failure plus other health issues.
We are in wales under the SS in Wrexham
If he qualifies for FNC, why do we need means testing? He already failed for CHC
Unless we paid all his money out, and left me with nothing.
Surely this is totally fightable
Does any one know how to go about it ?
My sanity is at an end, after ten years of caring
I have nothing left to give.
“FNC is to pay for the time of a registered nurse. Therefore, if your relative is not receiving care from a registered nurse, FNC will not be applicable.”
FNC is to pay for a registered nurse in a care home that has registered nurses – otherwise, NHS community nurses should be directing and overseeing the nursing care and treatment delivered by care and support workers (giving medication, continence care, pain & distress management, Skin care ….etc). Interesting to note that these NHS/LA community nurses would be responsible/accountable for ensuring that any social care and support workers are willing and able to deliver the nursing care a person needs and for developing the nursing care plans to direct the care workers deliver the health care. It may well be that the care workers do not have the time or skills to deliver the care so the community health services need to deliver health care and treatment such as monitoring and managing health conditions, rehabilitation, physiotherapy, occupational therapy, intermediate mental or physical health nursing or palliative care etc.
That’s the theory ???
I have found all the nursing homes in my area (south) are taking the FNC as,a bonus payment so they get an extra £1k per month for my mum, soon rising to £1500 pm. The NHS guidance says this,should be deducted from the bill but all of the care homes I looked into when we placed her refused to deduct it from the bill. That means gov funded patients pay £1500 less pm. I personally this this is fraudulent, even though contracts indirectly say they are entitled to steal it. It’s a major loophole that all the nursing homes seem to be,exploiting now. It was only 18 months ago my mums home changed their contract wording, prior to that they deducted FNC from the total bill.
I cannot believe the NHS are happy for this to continue but when I raised it with the CHC dept they didn’t want to know. Its legalised theft