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In a case that will resonate with all who are in care homes, or who have relatives or friends in care homes, the Court of Appeal recently made a significant ruling on who should pay for the care that state funded residents should receive. 

Sarah Nadin, solicitor and director at Banner Jones Solicitors said, “In today’s austerity environment the issue of who pays for what has become a key aspect of turf wars between government departments”.

The issue revolved around who should pay for the care of residents in care homes who required some nursing care but for whom nursing was not their primary need. Clinical or medical care, which must be provided by a registered nurse, is the financial responsibility of the NHS; whereas social care (for example help with washing or eating) is the responsibility of the local authority. Whilst the distinction may seem simple enough, what of a registered nurse that was employed at a care home but who provided services defined as “social”, and which did not therefore actually require a nursing qualification on the part of the carer, in addition to their clinical duties?

The local authorities argued that, where a registered nurse was required to be employed by the care facility it should be the responsibility of the NHS to fund them in full. The NHS argued that as they were only responsible for funding clinical care an apportionment should be made in each case. That is, the tasks performed by the nurse should be analysed on an individual basis and funding of each registered nurse should be appointed accordingly between the NHS and the Local Authority.

The Court of Appeal ruled in favour of the NHS and agreed that funding of qualified nursing staff should be shared between NHS and Local Authority on the basis of the types of task actually performed by the individual.

If you would like assistance in relation to residential care, call 0330 017 6309* to speak to our team or email

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Nikki Spencer
  • Senior Solicitor

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