NHS Funded Nursing Care UK (2026): The £235.88 Weekly Contribution for Nursing Home Residents

NHS Funded Nursing Care (FNC), also called NHS-funded nursing care or the registered nurse contribution, is a flat-rate weekly payment made by the NHS towards the cost of nursing care provided by a registered nurse in a care home registered to provide nursing care. FNC is provided under the NHS Act 2006 and Department of Health guidance: (1) WHO QUALIFIES: FNC is available to anyone who: (a) lives in a care home registered to provide nursing care (a 'nursing home'); (b) has been assessed by the NHS as requiring the input of a registered nurse to meet their needs; (c) does NOT qualify for full NHS Continuing Healthcare (CHC), if CHC is awarded, it covers the full cost of care and FNC becomes subsumed within CHC; (2) THE ASSESSMENT: FNC eligibility is determined by an NHS clinical assessment, typically carried out by a nurse or other clinician. The assessment uses 4 criteria to determine whether the person's needs require registered nursing input: (a) physical needs; (b) mental health needs; (c) learning disability needs; (d) other health needs. The assessment results in a finding of either: 'eligible for FNC' (registered nursing care needed) or 'not eligible for FNC' (personal care only; no registered nursing input needed). Unlike CHC, there is no complex multi-domain scoring, it is a straightforward clinical judgment about whether registered nurse involvement is needed; (3) THE RATE: the FNC rate for 2025-26 is £235.88 per week. This rate is set nationally and reviewed annually by NHS England. This is the standard rate, there is only one rate (there used to be higher and lower rates but these were merged in 2019); (4) WHO IS NOT ELIGIBLE: (a) residents of residential care homes (not nursing homes), FNC only applies to care provided in nursing homes; (b) people receiving domiciliary care (care at home), FNC is specific to nursing homes; (c) people who qualify for full NHS CHC, they receive full NHS funding, not just FNC.

FNC works differently depending on whether the nursing home resident is a self-funder (paying their own fees) or a council-funded resident: (1) SELF-FUNDERS: if you are paying your own nursing home fees privately (because your capital exceeds the £23,250 upper threshold), the FNC payment reduces your weekly fee. The process: (a) The NHS pays £235.88 per week directly to the nursing home on your behalf; (b) The nursing home deducts this from your total weekly fee; (c) Your net weekly payment is reduced by £235.88; Example: nursing home fee = £1,400/week; FNC = £235.88/week paid by NHS; your contribution = £1,164.12/week (not £1,400). Over a year, this saving is approximately £12,266. This saving applies from the date of FNC eligibility, it is not retrospective beyond the assessment date, but prompt assessment is important; (2) COUNCIL-FUNDED RESIDENTS: if the local authority is contributing to your nursing home fees (because your capital is below £23,250 or you have a Deferred Payment Agreement), the FNC operates differently: (a) The NHS pays £235.88/week directly to the nursing home; (b) The local authority's assessed contribution to the nursing element of care is reduced by the FNC amount, but your personal contribution (assessed income) does not change; (c) Effectively, the FNC reduces the burden on the local authority, not directly on the resident. The resident's Personal Expenses Allowance (£30.15/week) and assessed income contribution remain unchanged; (3) TRANSITION FROM SELF-FUNDER TO COUNCIL-FUNDED: when a self-funder's capital falls below £23,250, the local authority begins contributing to their care costs. At this point, the FNC continues to be paid to the nursing home, but the effect shifts from reducing the self-funder's direct contribution to reducing the local authority's liability; (4) THE THIRD-PARTY TOP-UP AND FNC: if a family member is paying a 'third-party top-up' to allow the resident to stay in a more expensive home than the council would normally fund, the FNC reduces the nursing home's total fee, this should reduce the top-up amount or the local authority's contribution accordingly.

NHS Funded Nursing Care (FNC) and NHS Continuing Healthcare (CHC) are frequently confused, but they are fundamentally different: (1) NHS CONTINUING HEALTHCARE (CHC), 100% NHS FUNDING: CHC provides full NHS funding for all health AND personal care needs for people with a 'primary health need'. If CHC is awarded, the NHS pays the entire cost of the nursing home placement, there is no means test, no care contribution from the resident, and no local authority involvement in care funding. The individual does not pay anything towards their care costs from their own assets. FNC is not separately identified when CHC applies, it is subsumed within the CHC package. The CHC assessment is complex: 12 care domains; Decision Support Tool (DST); Checklist screening; significant clinical judgment. Many eligible people are refused CHC and must challenge the decision; (2) NHS FUNDED NURSING CARE (FNC), PARTIAL CONTRIBUTION FOR NURSING CARE ELEMENT ONLY: FNC provides a fixed weekly contribution (£235.88/week in 2025-26) towards the nursing care element only. It does NOT cover personal care (help with washing, dressing, eating) or residential costs (room, meals, activities). FNC does NOT make the person's care free. The resident (or local authority) continues to pay for all other elements of the care package. The means test still fully applies for the remaining cost; (3) THE KEY DIFFERENCES IN SUMMARY: CHC: primary health need criterion; 100% NHS funded; no means test; complex assessment. FNC: registered nursing input needed; £235.88/week contribution only; means test continues to apply to remaining cost; simpler assessment; (4) THE RELATIONSHIP BETWEEN FNC AND CHC: if someone has FNC and their health needs deteriorate, a CHC assessment should be triggered. If CHC is awarded, FNC stops (it is replaced by full CHC funding). If CHC is refused, FNC continues as a partial contribution. People receiving FNC who believe they should qualify for CHC should request a CHC assessment, many CHC eligibility decisions are overturned on review; (5) WHERE PEOPLE GO WRONG: many families believe that because their relative is in a nursing home and receiving FNC, the NHS is 'paying for care'. FNC is only £235.88/week, a fraction of a typical nursing home fee of £800-£1,500+/week. Unless CHC has been awarded, the resident or local authority continues to bear the vast majority of the cost.

The FNC assessment process is triggered by the transition to a nursing home and managed by the NHS Integrated Care Board (ICB): (1) TRIGGERING THE ASSESSMENT: the FNC assessment should be carried out: (a) as part of the process of moving into a nursing home for the first time; (b) when the care home is assessed by the local authority or NHS in the context of a care package review; (c) at any point when there is reason to believe the person's nursing needs meet the FNC criteria. In practice, the nursing home or the hospital discharge team often initiates the assessment. If not, family members can request it by contacting the ICB or the care home manager; (2) THE ASSESSMENT PROCESS: the assessment is carried out by an NHS clinician (usually a nurse). They assess the person's nursing care needs against the 4 criteria (physical; mental health; learning disability; other). The nursing home may also provide documentation of the nursing care being provided. The assessment should be completed promptly, delays mean lost FNC payments; (3) BACKDATING: FNC payments can be backdated to the date the person first became eligible (typically the date of nursing home admission or the date when nursing needs became evident), provided the assessment confirms eligibility. Request backdating explicitly if there has been a delay in the assessment being carried out; (4) IF FNC IS REFUSED: if the clinician assesses that the person does not require registered nursing input and declines FNC eligibility: (a) request the reasons in writing; (b) ask for a copy of the assessment documentation; (c) request a local review through the ICB; (d) if still refused, the Parliamentary and Health Service Ombudsman can investigate; (e) consider whether CHC may be appropriate, if the nursing needs are substantial, a full CHC assessment should be requested alongside any FNC challenge; (5) PERIODIC REVIEW: FNC eligibility is reviewed periodically (typically annually or when there is a significant change in the person's condition). A review can result in FNC being confirmed, increased/adjusted (the rate is national so no change), or withdrawn (if nursing needs reduce). If FNC is withdrawn and you believe the assessment is wrong, challenge it using the same process as for initial refusals.

FNC has important interactions with estate planning and the care home means test, and having a registered LPA is essential for managing the process: (1) FNC AND THE MEANS TEST: FNC does not affect the capital thresholds for the care home means test (£23,250 upper; £14,250 lower). The FNC is a separate NHS payment and does not count as capital or income in the means test. However, as explained above, it reduces the weekly fee that the self-funder must pay, this slows the depletion of capital and can delay the point at which capital falls below £23,250 and the local authority begins to contribute. For estate planning purposes, the FNC extends the period of self-funding and therefore reduces the amount of capital spent before the local authority steps in; (2) FNC AND THE ESTATE: FNC is paid by the NHS to the nursing home and does not pass through the resident's estate. It cannot be claimed posthumously as an estate asset. However, if FNC was wrongly refused and the resident paid full nursing home fees that should have been reduced by FNC, a successful retrospective FNC eligibility decision can result in a refund to the estate; (3) LPA AND THE FNC PROCESS: if the nursing home resident has lost mental capacity, a Property & Financial Affairs LPA attorney is needed to: (a) engage with the ICB and nursing home about the FNC assessment; (b) manage the financial arrangements (paying the reduced fee; managing the DPA if relevant); (c) apply for any retrospective FNC payments; (d) request a CHC reassessment if nursing needs increase. Without an LPA, the deputyship process is required, making care management significantly more complex; (4) WILL PLANNING AND NURSING HOME: if a person in a nursing home has capacity, their will and LPA should be reviewed. Care home residence does not affect will-making capacity (separate from care capacity, MCA 2005 s.3). The will should address: what happens to the home (Deferred Payment Agreement charge; IPDI trust if jointly owned); pension expression of wishes (urgent review given Finance Act 2024 changes from April 2027); beneficiary arrangements reflecting updated financial position; (5) FNC AND ATTENDANCE ALLOWANCE: a person in a nursing home may still be entitled to Attendance Allowance (£108.55/wk higher rate, 2025-26), claim it. Attendance Allowance is not means-tested and is not taken into account in the care home means test income assessment.