Care homes get 40 per cent boost in nursing fees following costs review

Sharp rise in funded nursing care rates follows years of minimal increases and concerns over nursing shortages in homes

Nursing homes have received a 40% boost in the NHS fees they receive for work carried out by registered nurses, after a government-commissioned review found the previous rate fell substantially short.

The government has increased the standard NHS-funded nursing care (FNC) rate from £112 to £156.25 a week, as recommended by audit firm Mazars, based on its assessment of the “reasonable cost” of funding the service.

The higher FNC rate – paid to relatively few residents who were on the higher of the previous three bands that existed prior to 2007 – will also rise by 40% from £154.14 to £215.04 a week.

Nursing shortages

The news was welcomed by nursing home representatives, who have long lobbied for FNC to be reviewed, amid concerns over nursing shortages and their impact on the quality of care.

Concerns over nursing shortages in care homes have been raised by the Care Quality Commission in its last two State of Care reports. Vacancy rates for nurses in nursing homes are currently running at 8.4% while turnover rates are at 33%, latest figures from Skills for Care’s national minimum data set for social care show.


The new rates are an interim measure pending a further review of the element of the funding that covers agency staff, which may see a reduction in the FNC rate from January 2017. The Department of Health will also consult on reducing regional rates, as recommended by Mazars, after it found that they varied from being 24% above the national average in London to 7% below in the North.

What the fee is for

Funded nursing care is designed to fund services provided to nursing home residents by a registered nurse involving either the provision of care or the planning, supervision or delegation of the provision of care.

It is paid in England by clinical commissioning groups as under section 49 of the Health and Social Care Act 2001, registered nursing costs cannot be met by a local authority.

Prior to this increase, the rates received by nursing homes had only risen by 3% since 2010, in line with the squeeze on nurses’ pay over this time.


“The recognition by ministers and the Department of Health of the important role of nurses working in nursing homes and increasing the funding to residents for their nursing care, is welcome news,” said Martin Green, chief executive of care provider representative body Care England.

“Care England has worked tirelessly to ensure the rate of FNC was properly reviewed after so many years of nil or very low increases.”

Mazars based its recommended rates on costs information provided by 405 nursing homes. The rate includes the costs of direct nursing care, indirect nursing care (including planning and supervision of and delegation of work to other staff), paid breaks and an element of the time spent by nurses in delivering personal or social care in homes.

Variable costs

The Mazars review uncovered significant variability in nursing costs depending on the size or type of home. Homes with fewer than 30 beds faced average costs of £191.13, 57% above the £121.59 costs for those with more than 50 beds.

Nursing costs tended to be greater in homes for adults of all ages compared with those for just people aged over 65. Also, the review identified a group of homes providing specialist care for adults with physical disabilities with particularly high costs (£184.64 on average).

It recommended the DH consider the need for more detailed examination of the costs of FNC faced by specialist homes.

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