Fees and Funding Support Guide

There are a range of funding options available to those requiring short term, long term, assisted healthcare or social care provision. Whilst The Huntercombe Group does not provide grants or funding support of any kind, we have produced some helpful tips as to who to contact or where to look for advice or support on funding issues.

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The answer to this question will determine who you can approach for help. If you do not have a diagnosis at this stage or there are a range of issues associated with the patient/ client it is a good idea to make an appointment with their GP to look at what the long term prognosis is and what kind of support or service expectation might be needed.

There are two types of funding (aside from self funded where you or a family member pay for treatment or if an injury lawyer will be funding treatment) available in the UK, one is the NHS and the other is provided by your local authority. Usually the services The Huntercombe Group provide fall into these two funding streams but some patient cases may not always be so straightforward especially when two or more services are required at any one time.

At present the way the Health Service procures and/or provides services to its patients is via your local Primary Care Trust who currently are the responsible body for ensuring the best level of care is provided for its community.

This can also mean that in some circumstances where there are specialist needs such as intensive psychiatric care and a local hospital does not have the resource to provide such a service, Primary Care Trusts may look to commission independent providers or share services with other areas. This way of working is called ‘World Class Commissioning’ and as a patient it means you can expect the best care for your condition. World Class Commissioning also means that The Huntercombe Group can be commissioned to provide services to and on behalf of the NHS where Primary Care Trusts feel this is in the best interest of their community and patients. A referral to an independent healthcare provider will not affect the patient or their treatment in anyway and will be the same as if the patient has been referred to a local hospital or another department. In these circumstances it will all be paid for by Primary Care Trusts in the same way.

This usually applies to community or social care, where an individual or patient needs further assistance or support through an injury, illness or condition. Local Authorities should be contacted and they will then make arrangements to undertake a needs assessment, this will be undertaken by the social services department of the local authority and is provided for anyone requiring some form of community care because they are: elderly, disabled or suffering from a physical or mental illness. The rules of entitlement are complex and complicated and often it is a good idea to speak to your local Citizens Advice representative to be able to explain this in more detail.

If you are a carer, the NHS has a helpline for carers called Carers Direct which gives information and advice about community care services, benefits and other matters.

The helpline number is: 0808 802 0202 and you can go to their website at: www.nhs.uk/carersdirect.

In Scotland, Care Information Scotland provides a telephone and website service which gives information about community care services for older people in Scotland and their carers and families. The helpline number is: 08456 001 001. The website address is: www.careinfoscotland.co.uk

This information applies to England, Wales, Scotland and Northern Ireland

Severely disabled people may be able to apply to the Independent Living Funds (ILF) to help them live at home instead of in residential care.

The Independent Living Funds provide a direct payment that allows you to buy care from an agency or pay the wages of a privately-employed personal assistant.

Your local authority has to contribute a certain amount towards your care before the ILF will agree to help. This amount is £340 a week.

For more information about the ILF, go to their website at: www.ilf.org.uk.

In England and Scotland, you are entitled to get prescriptions free of charge if you:

  • are on Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or the guarantee credit part of Pension Credit. Your partner and children will also be entitled to free prescriptions. If you are getting Working Tax Credit and/or Child Tax Credit, you may be entitled to free prescriptions, depending on your income
  • are 60 or over (you must show proof of age to the pharmacist)
  • have a listed medical condition and have a valid medical exemption certificate. Ask your GP if you think this might apply to you
  • are having treatment for cancer, the effects of cancer or the effects of cancer treatment and you have a valid medical exemption certificate. You get free prescriptions for all NHS medication, not just the cancer medication (in England only)
  • you are on prescribed medication to prevent a pandemic disease, for example, pandemic influenza
  • have a continuing physical disability which means you cannot go out without help from another person and have a valid medical exemption certificate
  • are under 16 in England or Scotland. You must show proof to the pharmacist
  • get a war or service disablement pension, need prescriptions for your disability and hold an exemption certificate
  • are a prisoner
  • are pregnant, or have had a baby in the last twelve months and have a valid exemption certificate. This includes if you have had a miscarriage after the 24th week of pregnancy, or your baby was stillborn
  • have got a community care order and you are expected to take medication for the treatment of your mental disorder. This applies only to England.
In England, for a full list of people who can get help with prescription charges, see the Department of Health leaflet HC11 Help with health costs at: www.nhsba.nhs.uk.

To apply for a medical exemption certificate ask your GP, hospital or pharmicist for Form FP92A (EC92A in Scotland).

To apply for a maternity exemption certificate, ask your GP, midwife or health visitor for form FW8.

If none of the categories mentioned in this list applies to you, you may still be able to get free prescriptions on the grounds of low income.

In Scotland, for more information about help with prescription charges log onto http://www.infoscotland.com/prescriptions/.

If you need frequent prescriptions but do not qualify to get them free of charge, you can buy a prepayment certificate which will save you money.

In Scotland, you can get a certificate which lasts for either four or twelve months. You will usually benefit from buying a prepayment certificate if you have to pay for more than five prescription items in a four-month period, or more than 14 items in a twelve month period.

In England, you can get a prepayment certificate which lasts for either three or twelve months. You can pay for the twelve month certificate by direct debit, in ten equal monthly instalments.

Before buying a prepayment certificate, check that you are not entitled to free prescriptions, as it can be difficult to get a refund once you have paid for your certificate.

In England there are a number of ways to buy a prepayment certificate:

  • over the phone from the NHS Business Services Authority
  • from the NHS Business Services Authority website
  • from the pharmacist
  • from your Primary Care Trust
Contact details for the NHS Business Services Authority are:

NHS Business Services Authority
PPC Issue Office
PO Box 854
Newcastle Upon Tyne
NE99 2DE
Tel: 0845 850 0030
E-mail: ppc1@ppa.nhs.uk
Website: www.nhsba.nhs.uk.

In Wales, prescriptions are free so you don't need a prepayment certificate.

In Scotland you can buy a prepayment certificate at a pharmacy or from your doctor's surgery.

For more information about the costs of prepayment certificates, in England see NHS charges and optical voucher values and in Scotland see A quick guide to help with health costs (HCS2)

(Source: Citizens Advice and NHS Choices website)

Please note this is only a guide and is not intended to be a comprehensive solution. It is always a good idea to contact your local Citizens Advice Bureau. You can do this by searching for your nearest service and making an appointment. The Citizens Advice Bureau will also be able to advise you on whom to contact locally and will inform you about any application forms you may need to complete.