PIP and NHS CHC

[Itsuitsyou]

My dh has been assessed for and offered an NHS package of Continuing Health Care for Mental illness. He has also been assessed by the local authority and offered support from them. We now have to choose between NHS CHC and local council support. The company paid for by NHS CHC sound really good but I'm worried that if we choose NHS CHC this will negatively affect his PIP claim. He lives at home and will continue to do so, with me being his full time carer.

You can't choose if he is assessed as qualifying for CHC then that is what he will have. Not sure why it would affect his PIP?

Hi, OP.

Your husband's PIP is awarded on the basis of his needs, and he will still have those (high-level) needs, so my very quick answer is that no, according the regulations, it really should not affect his PIP.

CHC is a funded health need covered by NHS - will cover 100% of package of care or nursing placement. No topping up allowed, but also loose an element of choice in certain areas due to poor provision.
Local council covers "social needs" - anything that's not a primary health need basically, this will often have to be topped up.
You cannot have both.
PIP is a non means tested benefit and won't be affected.
Working for CHC for 8yrs, ask anything you want to know!

Thanks to everyone for all the replies.

This is a very interesting thread as I am sat here stressing!
My husband has PIP and ESA after a stroke and lived with me until he declined and moved to a care home under CHC in 2020. I informed PIP of the change and they continued his payments (which surprised me) and ever since I have worried that they got it wrong and we need to repay it all!!!

Then this morning I had a letter about his ESA, he has a living expenses component and Support Group component. I realise I did not update them about the change - only PIP.

Can anyone advise ?

So have you still been getting the PIP and ESA whilst all his care is paid for? I would let ESA know asap. Is it income related esa or contributions based. Are you on the ESA claim as his partner?

Yes, but I told PIP and they even spoke to the care nursing team a few weeks after I informed them, and they continued his payments!

on ESA it is support based and not income related. He was told that he would have this until retirement age. He is still employed but on long term sick and has been for 10 years. It is support and contribution based I think as he has health insurance and has always paid NI.

p.s. So he was told it was going to be paid indefinitely....and will remain in support group.

Does his ESA letters state you must tell them if any change of circumstances? The letters you get usually do, I know int if my mums friends moved into a care home and the husband had to claim as a single person because you aren't classed as being part of the same household.

I am totally unfamiliar about receiving PIP while living in a care home, Google says the care element should stop but mobility continue but if he's in a care home but the whole award should stop if it's a nursing home. Is he getting the full enhances for both? Is the PIP money being paid and managed by him or you?

You're supposed to let ESA know of changes yourself. PIP don't/wont always info share. The letters you get usually tell you that you must inform them of changes like decline in health, someone moving out or in and change of income etc.

My advice would be to get ESA claim updated asap as it's very possible he shouldn't be making a joint claim as you're no longer part of the same household. I'm not saying this to scare you, I'm only mentioning it because my Mums friend went through similar when her dh moved into a care home, they had to stop all joint claims and she had to claim seperatly as they were classed as no longer part of the same household.

Did/do you get carers allowance, you may want to check you've updated them too.

Have you informed council so that you're paying appropriate council tax?

I'd try not to panic or stress but I would get it sorted ASAP, maybe a citizens advice appointment to make sure you do everything correctly and claiming what you should be entitled to for yourself. It's a very confusing system and when someone you love is so ill it's very easy to overlook and make mistakes.

Esa is paid for living costs, so if most of his living costs are funded by CHC I would be surprised that it doesn't stop but then I am very surprised that the pp says PIP does continue. If someone is getting all their care funded not through CHC ( but by Local authority )then the daily living component would stop but maybe CHC is different. Seems odd though. If all care is funded why would someone need potentially over 1.2k a month in benefits which is what enhanced rates of PIP and ESA support group would be worth?
Op is your husband actually in a care home ( I may have assumed this form your post) or is he at home with a package of care ?

Sorry I think I'm getting confused here between op and Oldmumlauren. my reply was for Oldmum lauren.

I stand corrected. Just googled it and it seems it's not affected.

Age UK agrees with your first thoughts @Babyroobs

Age UK

Disability benefits
You should notify the Disability Benefits Centre if you get a disability benefit - Attendance Allowance (AA), Disability Living Allowance (DLA) or Personal Independence Payment (PIP) and are awarded NHS CHC.

If you receive NHS CHC in a nursing home, AA and both components of DLA and PIP are suspended after 28 days from when ICB funding begins, or sooner if you were recently in hospital.

If you receive NHS CHC in a residential home, AA and the care components of DLA and PIP are suspended after 28 days from when ICB funding begins, but DLA or PIP mobility components continue.

If you live at home with an NHS CHC care package, you can continue to receive these disability benefits. Check you are receiving them at the appropriate level.

Thanks Lougle. that's interesting, seems to be some conflicting information but Age Uk generally are very accurate.

I just can't understand why being funded by the NHS would be treated drastically different to being funded by a local authority ? It would surely be grossly unfair to those being funded by the local authority ? It is still public money and I can't imagine why you would continue to get benefits if all your living costs, food, shelter care are being paid for. I know they leave you a small allowance for personal expenses per week. If you are self funding it is completely different and you can continue to claim disability benefits. i will check with my social worker colleague tomorrow !

If funded by the LA someone is financially assessed to pay a contribution to the care. So they get benefits then pay the LA a certain amount.

If funded under CHC there is no financial contribution by the person.

Yes I understand that they don't have to contribute to costs but surely they can't also continue to get a benefit ( eg ESA) which is an income replacement benefit designed to pay for basic food and shelter when they are getting that all paid for?

Hi everyone,
I called ESA this morning and was told that his ESA continues. They said if there had been an issue they would have contacted me (as his appointee) before now. I am not sure why or how, but I am relieved that he does not have to pay it back as that is what I was worried about. His PIP and ESA is used to buy his clothes, toiletries and pay for small extras in his care package. Believe me I would prefer that he wasn't entitled and that he hadn't had a life changing illness that took the man I married away from me. :-(

His PIP was assessed when he declined further and had to move to care. PIP assessors talked to the team where he resides.

Thanks everyone for their comments.

Has your own entitlement changed though? They've told you that you're still entilted to be on a joint claim even though you're no longer part of the same household? Thats the part that sounds unusual and I'd still suggest you contact CAB or a charity that helps with benefits when you're no longer living together. Not necessarily because you're getting too much, you may find as you've been a single adult household for three years you personally are not getting what you're entitled to due to being on someone's joint claim who isn't part of your household.

I'm not saying he isn't entitled to what he receives, it's that you may not be getting what you personally should be as a single adult household. If his disability money is kept entirely separate from your household money then it's a big drop in money to cover things and by being part of his joint claim you could be worse off if that makes sense. It's worth looking into further if you feel able to. Or maybe use a benefits calculator to see what you'd be entitled to without his income added.

It is not a joint claim. It is entirely his claim. I do not claim benefits personally. My husband has ESA/PIP due to a stroke. I used to claim carers allowance when I gave up my job to care for him (which was a huge drop in income but necessary to support him). This carers allowance stopped when he went into care and I returned to work. We have one young child and I do not claim for anything at all as we are OK.
I act as his appointee as he does not have capacity himself.

My mistake, I thought when you replied yes to babyroobs earlier post it was in reply to her asking if you were part of a joint claim. I misunderstood.

If you're managing ok financially without his disability benefits as part of the household budget then that's ok, I just know things can be very tight running a household on a single income and it sounds like you have a lot to juggle.

Best of wishes for 2024.

Thank you very much for trying to help. It's the little things that sometimes make me realise it's not as lonely as it seems.