NHS-Funded Nursing Care

NHS-Funded Nursing Care is a payment the NHS makes directly to a nursing home for the registered nursing element of care provided to a resident who has nursing needs. It is available to people living in a care home with nursing registration (a nursing home) who do not qualify for full NHS Continuing Healthcare.

The current FNC rate is £235.88 per week (2025/26). This is paid by the NHS regardless of the resident's financial situation — it is not means-tested. The payment goes to the nursing home, not to the resident or their family. The effect is to reduce the weekly charge to the resident (or their funder) by the FNC amount.

FNC does not cover accommodation, personal care, or meals — only the registered nursing element. For a typical nursing home charging £1,500 per week, FNC reduces the fee to approximately £1,264 per week — still a significant sum that must be met by the individual, the council, or a third-party top-up.

FNC is available to nursing home residents who:

• Do not qualify for full NHS Continuing Healthcare;
• Are assessed as having needs that require the involvement of a registered nurse.

The FNC assessment is typically carried out as part of the CHC assessment process. If CHC is found to be inappropriate but the person has registered nursing needs, FNC should be automatically awarded. You do not need to apply separately for FNC — it should be considered at the same time as CHC.

FNC is reviewed regularly (at least annually) to ensure the nursing home continues to be the appropriate setting and that the resident's needs remain at the nursing care level. If needs decline significantly, FNC may be withdrawn and the person moved to a residential (non-nursing) care home setting.

How FNC interacts with care home fees depends on who is funding the care:

• Self-funders — If you are paying care home fees yourself, the care home should deduct the FNC amount from your weekly invoice. Always check that FNC is being applied — some homes include it in an all-inclusive fee, others invoice separately.
• Council-funded residents — If the council is funding your care home place, the council and the care home arrange the financial administration. The FNC payment reduces the amount the council pays to the home.
• Top-up situations — If a family is paying a top-up fee on top of the council's contribution, the FNC is applied to the care home's base fee, which may reduce the required top-up.

If you believe FNC should be being paid but is not, contact your Integrated Care Board (ICB) — the NHS body responsible for commissioning CHC and FNC in your area.

Being awarded FNC instead of full NHS Continuing Healthcare (CHC) is a common source of dispute. FNC contributes approximately £235.88 per week towards nursing care costs, whereas CHC covers the full cost of all care. If a person's needs are primarily health-related rather than social care in nature, CHC rather than FNC is the appropriate funding. The distinction matters enormously financially and should always be scrutinised where there is doubt.

If you believe the person should have been awarded CHC rather than FNC, you have the right to request a formal review. The first step is to ask the Integrated Care Board (ICB) for a full CHC assessment using the NHS Decision Support Tool (DST) if this was not carried out, or to review the DST scores if it was. The DST assesses twelve care domains (behaviour, cognition, communication, mobility, nutrition, continence, skin integrity, breathing, drug therapies, psychological, neurological symptoms, and other significant care needs) against four levels: no, low, moderate, high, and priority. A person who scores "priority" in any domain, or who has multiple "high" scores, is likely to qualify for CHC.

Formal challenges to FNC-only decisions can be made through the ICB's dispute and review process, then escalated to NHS England. If internal processes are exhausted without a satisfactory outcome, a complaint can be made to the Parliamentary and Health Service Ombudsman (PHSO). Many families find it helpful to engage an independent CHC specialist or a solicitor with experience of NHS funding challenges at this stage, as the process is complex and outcomes can hinge on how needs are described and evidenced in the assessment documentation.