Some people may be missing out

Which? magazine said there were too many ambiguities in the current system.

Often there were different sources of funding available, and each had "complex and conflicting" criteria, the report found.

Which? has called on the government to simplify the whole process to ensure everybody was treated fairly.

There are three main sources of funding for people - such as Alzheimer's patients - who need long-term care.

Full NHS continuing care funding - up to �1,000 a week - covers accommodation costs and all care needs.

But it is only available to those with "complex, intense or unpredictable" nursing needs.

Varying decisions

The government must admit that the current system is highly confusing for anyone who tries to negotiate it Malcolm Coles

Decisions on who qualifies for this funding vary across the country, with each strategic health authority (SHA) having its own criteria.

Last year the Health Service Ombudsman reviewed the system and recommended that each SHA review its criteria and give compensation where necessary.

Those people who cannot receive NHS funding are deemed to need "social" rather than "health" care, meaning they may receive some money from social services, subjects to means-testing.

Which? said that, despite the massive financial implications, the distinction between social and health care was not always clear.

Some patients could also get some form of help with the registered nursing care contribution, providing payments for people who receive care from a registered nurse but do not qualify for full NHS funding.

But Which? said there was little difference between the criteria for full NHS funding - worth thousands of pounds a month - and the criteria for the highest band of nursing care - just �125 a week.

Which? editor Malcolm Coles said: "The government must admit that the current system is highly confusing for anyone who tries to negotiate it.

"The Department of Health needs to clarify its guidance and make it clear exactly when the NHS is and isn't responsible for funding care."

Hilary Carter, from Help the Aged, said: "Older people and their families find themselves in a snakepit of complexity when trying to establish who pays for long-term care.

"Instead of a transparent and fair process which helps older people at a traumatic time of their lives, the current continuing care system is a confusing and distressing postcode lottery.

"Help the Aged believes it is essential to simplify the current system by providing free personal care at the point of need, as is done in Scotland.

"This is the only fair system which supports older people when they have long-term health care needs."

Government denies problem

Health Minister Stephen Ladyman said he did not accept the situation was confused - but he said the way it was reported was often confusing.

"When a person has a serious health need that meets criteria maintained by the local Strategic Health Authority, then both their health and personal care is fully funded by the NHS.

"This is known as NHS Continuing Care and is available no matter what causes your condition and is irrespective of where you receive care."

Mr Ladyman said any older person discharged from hospital or assessed for care for the first time will now be assessed using the Single Assessment Process that automatically includes an assessment for NHS Continuing Care.

"Anyone who thinks they have either missed out on an assessment for NHS Continuing Care or have been wrongly assessed in the past should contact their Primary Care Trust. Anyone who has been wrongly assessed will be fully compensated."