Six weeks of free care after hospital: intermediate care and D2A

In England, intermediate care and reablement after a hospital stay must be free for up to six weeks. This is set out in regulation 3 of the Care and Support (Charging and Assessment of Resources) Regulations 2014. It is not a right to six weeks of any care you choose: it covers short-term support aimed at getting someone back to independence, and anything long-term after that is usually means-tested.

In short

• Councils must not charge for intermediate care or reablement for the first 6 weeks (or the whole period if it is shorter).
• Community equipment and minor adaptations costing £1,000 or less are also free, with no time limit.
• Hospitals use “Discharge to Assess”: short-term support first, then a long-term assessment once the person has recovered as far as they are likely to.
• There are four discharge pathways, 0 to 3. Most people go home on pathway 0 or 1.
• Long-term care after the free period is means-tested: anyone with more than £23,250 in capital usually pays the full cost of a care home.
• Free care stops early if the person reaches their goals or no longer benefits from reablement.

What counts as free “intermediate care”

Intermediate care is a time-limited programme to help someone regain the skills to live at home. The regulations define it as care or support provided for a specified period to help an adult “maintain or regain the ability needed to live independently in their own home”. It comes in four broad forms:

• Reablement at home. Carers visit, often several times a day, and help the person relearn washing, dressing, making meals and moving safely. The aim is to do less over time, not more. Our guide to reablement explains a typical week.
• Home-based rehabilitation. Physiotherapists and occupational therapists visit to rebuild strength and mobility, for example after a hip fracture.
• Bed-based intermediate care. A short stay in a community hospital, care home or rehab unit before going home.
• Crisis response. Urgent short-term help to avoid a hospital admission in the first place.

The NHS part of intermediate care, such as therapy and nursing, is free at the point of use anyway. The six-week rule matters most for the social care part, which a council would otherwise means-test.

Also free: equipment and minor adaptations

The same regulation makes community equipment free, plus minor adaptations costing £1,000 or less. That includes grab rails, a raised toilet seat, a perching stool or a commode. There is no six-week cap on this. If you need larger work, such as a level-access shower, see home adaptations and ask for a free occupational therapy assessment.

How Discharge to Assess works

Discharge to Assess (D2A) is the model set out in the government’s Hospital discharge and community support guidance. The idea is simple: people should not wait in a hospital bed for a full long-term assessment. They leave as soon as they are medically fit, with short-term support, and their long-term needs are assessed once they are settled and stable. The guidance says no one should normally be discharged straight into a permanent care home placement without a temporary placement first.

Pathway 3 is where families most often get caught out. A short-term care home placement while long-term needs are assessed is not always classed as reablement. If the stay is simply a holding placement rather than a rehabilitation programme, the council may charge from day one. Ask in writing which category the placement falls under.

The old NHS-funded discharge period has ended

During the pandemic, the NHS paid for a period of care after discharge for everyone (up to six weeks at first, later four). That scheme ended in March 2022. Some families still hear about “free care after hospital” from friends who used it. Today the free element depends on the care being intermediate care or reablement.

What happens when the six weeks end

Before the free period ends, the reablement team should review progress. There are usually three outcomes:

1. No ongoing care needed. The person has regained their independence and support stops.
2. Ongoing care at home. The council carries out a Care Act needs assessment and, if the person has eligible needs, a financial assessment. Our guide to what happens after reablement ends covers this step.
3. A move to a care home. If the person cannot safely return home, a permanent placement is discussed, ideally with the person’s own views at the centre.

Councils can choose to keep reablement free beyond six weeks if more progress is likely, but they do not have to. If your parent is clearly still improving at week five, ask for an extension in writing and give examples of recent gains.

Worked example

Joan, 84, breaks her wrist and goes home on pathway 1. She gets four reablement visits a day for six weeks, free of charge. At the review she still needs help to shower and dress, so she is assessed for ongoing home care of 7 hours a week. She has £18,000 in savings and a State Pension of £241.30 a week. Her savings are between the lower limit of £14,250 and the upper limit of £23,250, so £15 a week of tariff income is counted. She is single and over Pension Credit age, so the Minimum Income Guarantee of £241.45 a week is protected. In practice, her weekly charge will be modest. If she also claimed Attendance Allowance at £76.70 a week, that would count as income, but disability-related expenses can be offset. Use our funding checker to model a similar case.

When care after hospital is not free

• Long-term care from the start. If the plan is long-term home care with no reablement goal, it is means-tested from day one.
• Self-arranged care. Care you book privately, without a council or NHS referral, is not covered.
• Top-ups or extra hours. Extra visits or a more expensive room you choose yourself are your cost.
• After the goals are met. Reablement can end before week six if the person is independent or is not expected to benefit further.
• Refusing reablement. If someone with capacity declines reablement and asks for ordinary care instead, that care can be charged.

The exception is people discharged after detention under certain sections of the Mental Health Act 1983. Their aftercare under section 117 is free for as long as it is needed, not just six weeks.

Check for NHS Continuing Healthcare

If your parent’s needs are mainly health needs, the whole cost of care could be paid by the NHS through NHS Continuing Healthcare (CHC). The national framework says the CHC Checklist should usually be done once the person has left an acute hospital bed, when their needs are clearer, not in the rush of discharge. Ask the discharge team or the reablement team when it will happen and who will do it.

A positive Checklist leads to a full assessment by a multidisciplinary team. If your parent is approaching the end of life, the fast-track CHC route can arrange funding within days. You can test the likelihood with our NHS Continuing Healthcare checker. If CHC is refused but your parent needs nursing in a care home, they should get NHS-funded nursing care instead.

How to ask for free intermediate care

1. Ask early. As soon as a discharge date is mentioned, ask the ward: “Which discharge pathway is my parent on, and is reablement included?”
2. Get it in writing. Ask for the start date, the planned length and which costs are free.
3. Ask for a carer’s assessment. If you will be helping, the council must offer you one. Unpaid carers should be involved in discharge planning from the start.
4. Request the CHC Checklist where health needs are significant.
5. Prepare for the six-week review. Keep a short diary of what your parent can and cannot do. Our guide to preparing for a care needs assessment has a checklist.

Mistakes to avoid

• Assuming the first care home your parent goes to on discharge is permanent. On pathway 2 or 3 it is often temporary, and you can choose a different home for the long term.
• Signing a self-funding contract during a free placement without checking who is paying.
• Letting the free period run out without a review date. Ask for one in week four.
• Selling the home in a hurry. If a permanent care home move follows, the 12-week property disregard gives breathing space.

Scotland, Wales and Northern Ireland

The six-week rule above is English law. In Wales, reablement is free for up to six weeks under Welsh charging rules. Scotland does not charge for personal care for adults assessed as needing it, and many Scottish councils also provide short-term reablement free. In Northern Ireland, home care is generally free of charge, so the six-week distinction matters less. Check with the local health and social care trust or council.

Frequently asked questions

Is care free for six weeks after leaving hospital?

Only intermediate care and reablement are free, for up to six weeks, under the Care and Support (Charging and Assessment of Resources) Regulations 2014. Ordinary long-term home care or a permanent care home place is means-tested. Equipment and minor adaptations costing £1,000 or less are free with no time limit. Ask the discharge team in writing which type of care your parent is getting.

What is Discharge to Assess?

Discharge to Assess means a patient leaves hospital once medically fit, with short-term support in place, and their long-term needs are assessed later at home or in a community bed. It avoids long waits in hospital and avoids decisions about permanent care being made while someone is still unwell. There are four pathways, numbered 0 to 3.

What happens after six weeks of reablement?

The reablement team reviews progress. If no further care is needed, support stops. If ongoing care is needed, the council carries out a needs assessment and a financial assessment, and the person may have to pay. People with savings over £23,250 usually pay the full cost. Councils can choose to extend free reablement if more progress is likely.

Can reablement end before six weeks?

Yes. Six weeks is a maximum, not a guarantee. Reablement can stop early if the person meets their goals or the team decides they are not likely to benefit further. If you disagree, ask for the reasons in writing and request a review, giving specific examples of the progress your parent is still making.

Do you pay for a care home after hospital discharge?

A short stay in a care home for rehabilitation on pathway 2 is free for up to six weeks. A placement on pathway 3 that is mainly for assessing long-term needs may be charged from the start, unless NHS Continuing Healthcare applies. Ask the council to confirm in writing how the placement is classed before signing anything.

When is the NHS Continuing Healthcare checklist done?

Under the national framework, the CHC Checklist should usually be completed after the person leaves an acute hospital bed, once their ongoing needs are clearer. It can be done in a community bed or at home during reablement. If someone is nearing the end of life, the fast-track tool can be used immediately.

Sources

• Care and Support (Charging and Assessment of Resources) Regulations 2014, regulation 3
• GOV.UK: Hospital discharge and community support guidance
• GOV.UK: Care and support statutory guidance
• GOV.UK: National framework for NHS continuing healthcare and NHS-funded nursing care
• NHS: Care after a hospital stay

General information, not legal or financial advice. Figures for 2026/27, checked October 2026.

Reviewed by The Care Panel team on 29 October 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.