Can anyone explain in simple terms section 117 funding. My Mother had a CPA meeting today where I was expecting talk to be re her discharge from hospital and care plan for going home. However the bad news was she has had a turn for the worse and they now suggest she goes into residential care. The 'good news' as she was sectioned under Section3 of the mental health act apparently she will get section 117 funding. I don't really know what this means.
Section 117 funding
- Thread starter Susan y
- Start date
Hi Susan, sorry to hear about your mum. It's always a shock to the system to be told that the person you are for has to go into care.
On the positive side, it's always easier to transfer directly from hospital rather than having to leave home.
Financially, it is indeed good news, it means your mum will be fully funded by the NHS for all her care.
Love,
PS forgot to welcome you to TP!
On the positive side, it's always easier to transfer directly from hospital rather than having to leave home.
Financially, it is indeed good news, it means your mum will be fully funded by the NHS for all her care.
Love,
PS forgot to welcome you to TP!
I think it means that your mother will not have to pay for her acommodation. She will keep her pension and her assets. My husband was also on on a Section III which was transferred to a 117 Continuing Care order. I'm not quite sure who pays for the acommodation but I think it is joint between social services and the local Mental Health Trust.
I provide the monies for all my husbands other expenses such as clothing, hair cutting (which I do myself), toiletries, cigarettes, wine (he has a glass or two each night), etc., etc., out of his pension which is paid into our bank account. It's not a large pension by any means, not even the basic pension in fact. I have also left £50 in the office safe in case I'm ever ill and can't get things for him (not needed to use this thank goodness).
It seems so unfair to draw a line in this arbitary way. Every person suffering from Dementia is suffering from a serious, degenerative disease which may mean that nursing/specialist EMI residential care could be needed. Yet unless a Section III has been made, they will have to pay for the service. - Cradle to Grave - BAH!! Humbug!!! I really cannot understand why Dementia has this unfair and unjust division!! Any other serious, degenerative disease would not be treated in this way. I think it has to do with the fact that many sufferers are elderly and the powers that be cannot distinguish between elderly, failing health which in our 'caring society' is not deemed to be paid for by the state regardless of the fact that 24 hour care is needed.
The argument is that we should all be able to take care of our own financial needs as we get older and frail. Everyone knows that they will (if they are lucky enough) live to reach old age and should have saved for this during their lifetime. Therefore whatever assets they have accrued during their lifetime should contribute to their old age needs.
I would suggest that over a lifetime of working and paying taxes and NI contributions, this has already been paid in full. Many, many of the older generation have very rarely needed health treatment which dipped into their NH contributions up and until they became old and had multiple health problems which incidentally, contribute to their need for residential acommodation.
This is an injustice which every government, regardless of party politics have 'ducked' successfully until now. They produce the argument that as longevity increases and births decrease, they cannot see how the state can be expected to fund 'old age'. A ridiculous argument as many pensioners look after themselves for many, many years into retirement and hopefully when it is time to die, they die in their own beds without ever dipping into the 'national purse'. As preventative health continues to improve, I can forsee pensioners taking care of themselves quite successfully well into old age!
Which leads me back to the fact that the sick elderly, and those needing residential care, should get fully funded care.
................. I'm sure you didn't want to know all of this when you asked the question, but here on TP one question often leads to a wider question being posed.
xxTinaT
I provide the monies for all my husbands other expenses such as clothing, hair cutting (which I do myself), toiletries, cigarettes, wine (he has a glass or two each night), etc., etc., out of his pension which is paid into our bank account. It's not a large pension by any means, not even the basic pension in fact. I have also left £50 in the office safe in case I'm ever ill and can't get things for him (not needed to use this thank goodness).
It seems so unfair to draw a line in this arbitary way. Every person suffering from Dementia is suffering from a serious, degenerative disease which may mean that nursing/specialist EMI residential care could be needed. Yet unless a Section III has been made, they will have to pay for the service. - Cradle to Grave - BAH!! Humbug!!! I really cannot understand why Dementia has this unfair and unjust division!! Any other serious, degenerative disease would not be treated in this way. I think it has to do with the fact that many sufferers are elderly and the powers that be cannot distinguish between elderly, failing health which in our 'caring society' is not deemed to be paid for by the state regardless of the fact that 24 hour care is needed.
The argument is that we should all be able to take care of our own financial needs as we get older and frail. Everyone knows that they will (if they are lucky enough) live to reach old age and should have saved for this during their lifetime. Therefore whatever assets they have accrued during their lifetime should contribute to their old age needs.
I would suggest that over a lifetime of working and paying taxes and NI contributions, this has already been paid in full. Many, many of the older generation have very rarely needed health treatment which dipped into their NH contributions up and until they became old and had multiple health problems which incidentally, contribute to their need for residential acommodation.
This is an injustice which every government, regardless of party politics have 'ducked' successfully until now. They produce the argument that as longevity increases and births decrease, they cannot see how the state can be expected to fund 'old age'. A ridiculous argument as many pensioners look after themselves for many, many years into retirement and hopefully when it is time to die, they die in their own beds without ever dipping into the 'national purse'. As preventative health continues to improve, I can forsee pensioners taking care of themselves quite successfully well into old age!
Which leads me back to the fact that the sick elderly, and those needing residential care, should get fully funded care.
................. I'm sure you didn't want to know all of this when you asked the question, but here on TP one question often leads to a wider question being posed.
xxTinaT
And also, every now and then someone feels the need to say spot on, TinaT. Absolutely spot on!!
There comes a time when someone has to say ... come on, Governments, this is not what we all want you to do. We would like you to acknowledge where we all stand in this debate, but ... they don't listen to us, do they?
And no matter how hard we all work in our own worlds, in our own ways, we just don't seem to be listened to, we just don't seem to have found the back-up that we need.
That support which really says we are behind you, we are with you, we will do our best for you.
It just is not there.
To quote Delia Smith, when she was on a 'bad hair day' on the football pitch: Where are you all? Come on!
And that's the message I would personally send to Joan Bakewell, who is supposed to be our Ambassador/Champion. Where are you Joan?
And that message is exactly the same one that I understand is being sent by a good few other people: where are you, Joan Bakewell?
.
Hi Susan y,
Welcome to Talking Point (TP), though I'm sorry it's under such difficult circumstances.
You might want to look at this Alzheimer's Society Factsheet that covers Section 117:
http://www.alzheimers.org.uk/factsheet/459
Take care,
Welcome to Talking Point (TP), though I'm sorry it's under such difficult circumstances.
You might want to look at this Alzheimer's Society Factsheet that covers Section 117:
http://www.alzheimers.org.uk/factsheet/459
Take care,
In the simplest terms it means that your Mother will continue to be treated as though she were in a hospital financially speaking, which means that the costs will be met by the NHS and her own assets such as pensions, property etc will not be affected. However, any additional services which are not considered to be part of essential basic care - for example, if she wanted a hairdresser to visit - then this would have to be paid for.
In purely financial terms, a Section 117 is the best and easiest option, because the person under it is treated as having an ongoing illness, and thus all care costs are met by the NHS. There is no battle, for example, to try to get Continuing Care funding.
What makes my blood boil is that people with degenerative conditions are often treated as though they were not suffering from an illness, and hence don;t get funding form the NHS. For example, if you have to go into care because you are "merely" old and frail and need lots of help, then you're not "ill" and thus the NHS doesn;t come into it (excluding purely medical requirements); dmementia is very often placed in this category as well.
If someone had all the symptoms of dementia, but the cause was a brain tumour, there would be no questions asked: however, if the cause is Alzheimer's Disease, then quite often there is an uphill battle to get NHS funding.
In purely financial terms, a Section 117 is the best and easiest option, because the person under it is treated as having an ongoing illness, and thus all care costs are met by the NHS. There is no battle, for example, to try to get Continuing Care funding.
What makes my blood boil is that people with degenerative conditions are often treated as though they were not suffering from an illness, and hence don;t get funding form the NHS. For example, if you have to go into care because you are "merely" old and frail and need lots of help, then you're not "ill" and thus the NHS doesn;t come into it (excluding purely medical requirements); dmementia is very often placed in this category as well.
If someone had all the symptoms of dementia, but the cause was a brain tumour, there would be no questions asked: however, if the cause is Alzheimer's Disease, then quite often there is an uphill battle to get NHS funding.
Joan Bakewell? Does she post on here? If she is our champion, the odd message from her, or update on her progress for our cause, might be helpful.
Am I being cynical?
The problem of financing the elderly with mental health problems should be at the forefront of all political parties. We will have a general election in the next year. Let us start now, lobbying our MPs (and the PPCS who are hoping to beat them).
Margaret
Am I being cynical?
The problem of financing the elderly with mental health problems should be at the forefront of all political parties. We will have a general election in the next year. Let us start now, lobbying our MPs (and the PPCS who are hoping to beat them).
Margaret
Thank you all for your original replies . I have now found a place in a Residential EMI for my Mum however she can't move in until financial issues are in place. I am still confused about Section 117. Your replies seemed to say that I wouldn't have a problem but our CPN tells me that the funding will come from Social Services re section 117 continuing care and they have an upper limit of £450. The only home I can find for this is a local authority home which quite literally stinks!
Confused and fed up.Susan
Confused and fed up.Susan
Hello Susan
I think that your CPN hasn’t quite got it right, perhaps.
Continuing Care funding comes via the NHS, not from Social Services. And there is no upper limit to NHS CC funding – it pays for whatever needs to be paid for.
Read Nebiroth’s post above (no. 6) above. It tells you all you need to know.
I'll find a link for you and add it later, if I find it.
Have a read of page 5 of http://www.ageconcern.org.uk/AgeConcern/Documents/FS10Paying_for_permanent_residential_care.pdf
And another link http://www.dementiaweb.org.uk/who-pays-for-dementia-care.html which says:
Care Following Section Under Mental Health Act
Section 117 of The Mental Health Act (1983) requires statutory authorities to make arrangements for the continued care of a person who has been detained under Section 3. This care must be provided free of charge. An example of this would be when a person with dementia has been detained in hospital for treatment under Section 3 and is then discharged to a Nursing Home.
Don't worry about the use of the word 'nursing home' - NHS CC is available in any residential setting, and in one's own home.
.
I think that your CPN hasn’t quite got it right, perhaps.
Continuing Care funding comes via the NHS, not from Social Services. And there is no upper limit to NHS CC funding – it pays for whatever needs to be paid for.
Read Nebiroth’s post above (no. 6) above. It tells you all you need to know.
I'll find a link for you and add it later, if I find it.
Have a read of page 5 of http://www.ageconcern.org.uk/AgeConcern/Documents/FS10Paying_for_permanent_residential_care.pdf
And another link http://www.dementiaweb.org.uk/who-pays-for-dementia-care.html which says:
Care Following Section Under Mental Health Act
Section 117 of The Mental Health Act (1983) requires statutory authorities to make arrangements for the continued care of a person who has been detained under Section 3. This care must be provided free of charge. An example of this would be when a person with dementia has been detained in hospital for treatment under Section 3 and is then discharged to a Nursing Home.
Don't worry about the use of the word 'nursing home' - NHS CC is available in any residential setting, and in one's own home.
.
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Hi Susan
If you can’t find an appropriate home that falls within Social Services’ budget, then I’d suggest that you need to make an argument around what is in your mum’s ‘best interests’ (i.e. it would not be in her best interests to be moved into a home that does not provide X or Y, or is too far away from yourself or other family members, etc). Think of all the specific reasons why this home would not be appropriate for your mum and put these reasons to Social Services.
Social Services may have their budgets and upper limits, but regardless of these, they have a duty to act in the best interests of those in their care. If you can show that this home would not meet your mum's needs, then SS would have a duty of care to your mum, to place her elsewhere.
The following AS factsheet deals with similar issues (see q.3) and also cites examples of relevant case law.
http://www.alzheimers.org.uk/site/scripts/documents_info.php?categoryID=200202&documentID=163
Best wishes,
Katherine
Hi Susan,
This is really a bit of a specialist area, so it might be worth contacting the Alzheimer's Society Helpline:
http://www.alzheimers.org.uk/helpline
From what I've read online, people subject to section 117 are the joint responsibility of the Primary Care Trust and local social services. It is down to both bodies to agree a joint funding formula for people on a section 117.
One document I found (Surrey) had guidelines for when the NHS paid the cost, when SS paid the cost and when they shared 50/50.
My limited understanding is that they have to fund a place that meets your mother's assessed level of need. Maximum weekly costs don't come into it, but if they can find a home that charges £450/week and it can meet her needs, then they will push for that solution. It's worth remembering that meeting your mother's needs can also include a reasonable distance for you to be able to visit her regularly.
The Surrey guidelines (http://www.sabp.nhs.uk/foi/policies/alphabetical/S-U/0003%20Section%20117%20-%20Policy%20on%20Aftercare%20_2_.pdf/) had this to say:
Here is the similar document for the area that includes Bristol:
http://www.awp.nhs.uk/FOI%20Documents/cpc_26.pdf
It may be that the section 117 will be withdrawn in the future, but then your mother might qualify for NHS Continuing Care. I wonder what would happen if she was assessed for NHS CC now? Perhaps the Helpline can advise.
Take care,
This is really a bit of a specialist area, so it might be worth contacting the Alzheimer's Society Helpline:
http://www.alzheimers.org.uk/helpline
From what I've read online, people subject to section 117 are the joint responsibility of the Primary Care Trust and local social services. It is down to both bodies to agree a joint funding formula for people on a section 117.
One document I found (Surrey) had guidelines for when the NHS paid the cost, when SS paid the cost and when they shared 50/50.
My limited understanding is that they have to fund a place that meets your mother's assessed level of need. Maximum weekly costs don't come into it, but if they can find a home that charges £450/week and it can meet her needs, then they will push for that solution. It's worth remembering that meeting your mother's needs can also include a reasonable distance for you to be able to visit her regularly.
The Surrey guidelines (http://www.sabp.nhs.uk/foi/policies/alphabetical/S-U/0003%20Section%20117%20-%20Policy%20on%20Aftercare%20_2_.pdf/) had this to say:
Here is the similar document for the area that includes Bristol:
http://www.awp.nhs.uk/FOI%20Documents/cpc_26.pdf
It may be that the section 117 will be withdrawn in the future, but then your mother might qualify for NHS Continuing Care. I wonder what would happen if she was assessed for NHS CC now? Perhaps the Helpline can advise.
Take care,
Your CPN is wrong. Section 117 patients are funded by the NHS, not Social Services although both the Primary Care Trust and the local authority share the responsibility towards the patient.
My guess is that the NHS tend to "farm out" patients to the local authority, since the LA probably arrange for residential care for a lot more people and are better placed to know local facilities, to negotiate rates, etc.
Notwithstanding, your mother MUST be placed where her best interests are served, and "upper limits" are irrelevent to this. If your mum's needs can only be met in a place that charges three times the "upper limit", then the funding will still come from the NHS. They cannot refuse to place her due to budgetary constraints - the alternative wouold be for mum to remain in hospital, which would cost a lot more and this is one of the primary causes of bedblocking.
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Thanks again for your help. i am now at my wits end.
The social worker has insisted today that my mother can only go into a home that charges up to a maximum of £496 per week although she can't suggest anywhere that charges this. she has given me a list of three homes that I should phone and ask for prices! I've had enough, I'm on my own with two young children and have mental health problems of my own. I asked if we could pay a top up and she says not from my mothers funds, so I suggested I pay with my child tax credits!My only other suggestions are 1) Mum stays in hospital 2)I sell my house then I will have the funds to pay the top up....where will I live? there will be a nice house empty that I'm sure I can rent cheaply. Sorry i am in tears writing this as I don't know what to do.
The social worker has insisted today that my mother can only go into a home that charges up to a maximum of £496 per week although she can't suggest anywhere that charges this. she has given me a list of three homes that I should phone and ask for prices! I've had enough, I'm on my own with two young children and have mental health problems of my own. I asked if we could pay a top up and she says not from my mothers funds, so I suggested I pay with my child tax credits!My only other suggestions are 1) Mum stays in hospital 2)I sell my house then I will have the funds to pay the top up....where will I live? there will be a nice house empty that I'm sure I can rent cheaply. Sorry i am in tears writing this as I don't know what to do.
Susan, the situation you describe is ridiculous.
Your Social Worker is talking utter rubbish!!
Please don't let it get to you.
Difficult, yes, but your SW is talking utter nonsense. If your Mum is in hospital under a Section 3, then you do not need to be put through this distress.
If you have a local Alz Soc branch, get in touch with them tomorrow.
If you have a local Age Concern branch, get in touch with them tomorrow.
If you have a CAB branch locally, get in touch with them tomorrow.
If you have a MIND branch locally, get in touch withe them tomorrow.
Any one of the above 4 would be a positive move, but I'd go for the MIND branch.
And if I were you, with your own problems, then I would talk to your own GP and explain the situation in full. Ask your GP to be the 'go-between' between your Mum's Social Worker and you, for the time being, just to give you some breathing space - perhaps your GP will be able to get some sense from the SW. Do you have the same GP as your Mum? That would be useful.
The one thing I recommend you do - and this may sound harsh - do not allow your Mum to be discharged from hospital until this is all sorted. And make sure the GP and Social Worker and the Hospital know this.
Have you talked to the Consultant at the hospital about it all? Or is it just the SW that is giving you this rubbish information?
Main thing, don't worry - Social Workers often get this sort of thing completely wrong, and remain in blissful ignorance.
Stay calm!
PS. If you can face printing this link out and putting it into the hands of your Social Worker, it might concentrate their attention:
http://www.communitycare.co.uk/Arti...der-section-117-of-the-mental-health-act.html
.
Your Social Worker is talking utter rubbish!!
Please don't let it get to you.
Difficult, yes, but your SW is talking utter nonsense. If your Mum is in hospital under a Section 3, then you do not need to be put through this distress.
If you have a local Alz Soc branch, get in touch with them tomorrow.
If you have a local Age Concern branch, get in touch with them tomorrow.
If you have a CAB branch locally, get in touch with them tomorrow.
If you have a MIND branch locally, get in touch withe them tomorrow.
Any one of the above 4 would be a positive move, but I'd go for the MIND branch.
And if I were you, with your own problems, then I would talk to your own GP and explain the situation in full. Ask your GP to be the 'go-between' between your Mum's Social Worker and you, for the time being, just to give you some breathing space - perhaps your GP will be able to get some sense from the SW. Do you have the same GP as your Mum? That would be useful.
The one thing I recommend you do - and this may sound harsh - do not allow your Mum to be discharged from hospital until this is all sorted. And make sure the GP and Social Worker and the Hospital know this.
Have you talked to the Consultant at the hospital about it all? Or is it just the SW that is giving you this rubbish information?
Main thing, don't worry - Social Workers often get this sort of thing completely wrong, and remain in blissful ignorance.
Stay calm!
PS. If you can face printing this link out and putting it into the hands of your Social Worker, it might concentrate their attention:
http://www.communitycare.co.uk/Arti...der-section-117-of-the-mental-health-act.html
.
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I agree. The Social Worker is talking nonsense.
As I understand it:
At present, the hospital has a duty of care towards your mum as a patient. They surely cannot discharge mum until suitable arrangements have been made.
Social Services also have a legal duty of care to vulnerable persons.
A relative cannot legally be held responsible for the care of another relative (excluding that of a dependent child).
In short, you cannot be required to provide care, to arrange for it, or to pay for it.
This Factsheet may also be of interest:
http://alzheimers.org.uk/factsheet/453
It sounds as though you need the urgent advice of say MIND or a Citizens Advice.
You might also speak to the Social Worker's supervisor. Also, try contacting the hospital and see if they have anyone who is specifically responsible for the discharge pf patients who will require further care once they leave hospital.
What would happen if you mum had no children, or you were estranged from her? It would all have to be done by Social Services anyway.
As I understand it:
At present, the hospital has a duty of care towards your mum as a patient. They surely cannot discharge mum until suitable arrangements have been made.
Social Services also have a legal duty of care to vulnerable persons.
A relative cannot legally be held responsible for the care of another relative (excluding that of a dependent child).
In short, you cannot be required to provide care, to arrange for it, or to pay for it.
This Factsheet may also be of interest:
http://alzheimers.org.uk/factsheet/453
It sounds as though you need the urgent advice of say MIND or a Citizens Advice.
You might also speak to the Social Worker's supervisor. Also, try contacting the hospital and see if they have anyone who is specifically responsible for the discharge pf patients who will require further care once they leave hospital.
What would happen if you mum had no children, or you were estranged from her? It would all have to be done by Social Services anyway.
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Hi Susan,
It sounds as if your social worker has a very poor grasp of the way a Section 117 works. It sounds as if she is treating your mum as if she was a normal discharge from hospital with social services contributing a maximum weekly amount towards her care (and she's even wrong on the ability of SS to set an arbitrary maximum).
The bottom line is:
I've attached a really useful short document on 117 care from Rethink (at the bottom of this post). You might consider ringing their helpline tomorrow morning:
http://www.rethink.org/how_we_can_help/advice_service_and_information/index.html
It does seem that local councils do have a poor history in knowing how to handle section 117's:
http://www.communitycare.co.uk/Articles/2009/01/29/110508/free-aftercare-services-under-section-117-of-the-mental-health-act.html
Please don't allow yourself to be pressured into taking on something that you are not responsible for. Once you have contacted the relevant helplines and got the facts clear in your own mind, make sure the social worker knows that you are aware of the NHS/SS responsibilities.
Take care,
It sounds as if your social worker has a very poor grasp of the way a Section 117 works. It sounds as if she is treating your mum as if she was a normal discharge from hospital with social services contributing a maximum weekly amount towards her care (and she's even wrong on the ability of SS to set an arbitrary maximum).
The bottom line is:
- The NHS/SS have to meet the full costs of your mother's care while she is under the section 117.
- The authorities are responsible for assessing your mum's needs and preparing a care plan.
- The authorities are responsible for finding a home that meets your mum's care needs.
I've attached a really useful short document on 117 care from Rethink (at the bottom of this post). You might consider ringing their helpline tomorrow morning:
http://www.rethink.org/how_we_can_help/advice_service_and_information/index.html
It does seem that local councils do have a poor history in knowing how to handle section 117's:
http://www.communitycare.co.uk/Articles/2009/01/29/110508/free-aftercare-services-under-section-117-of-the-mental-health-act.html
Please don't allow yourself to be pressured into taking on something that you are not responsible for. Once you have contacted the relevant helplines and got the facts clear in your own mind, make sure the social worker knows that you are aware of the NHS/SS responsibilities.
Take care,
