Why are sick and vulnerable people in Salford, Greater Manchester three times as likely to get their day-to-day care for free from the NHS as their neighbours in Bolton? Why are they three times less likely to have to spend their life savings or even sell their house to get these essential services? Answer: because the former come under the care of Salford Clinical Commissioning Group (CCG), while the latter are dependent on Bolton CCG to assess their needs.
CCGs are responsible for arranging and funding NHS Continuing Healthcare (NHS CHC) for all eligible individuals. The funding should cover all care requirements that arise as the result of a “primary health need”. This could be anything from severe dementia to Multiple Sclerosis to the effects of a stroke.
One of the biggest postcode lotteries in the NHS
NHS CHC is one of the biggest postcode lotteries within the NHS. Eligibility rates vary massively between different CCGs, even where they cover similar populations.
Greater Manchester is one of the UK regions worst affected by the NHS CHC postcode lottery. The latest figures, which cover the third quarter of 2018, show that Bolton CCG had 384 people assessed as eligible for NHS CHC, equivalent to just over 80 people for every 50,000 of the population. Down the road, Salford CCG assessed more than 1,000 people as eligible for the funding or 230 per 50,000 of the population. In other words, almost three times as many.
Things are even worse in the South of the Greater Manchester region, in areas such as Stockport and Trafford. Over the same period, Stockport CCG deemed that just 145 people, or 29 per 50,000 of the population, were eligible to have their care costs met by the NHS. That is just 12.5 per cent of the Salford figures. In Trafford, one of the wealthiest areas of Greater Manchester, the figure was 156, or 41 per 50,000 – less than 18% of the Salford figure.
Oldham residents lose out hugely from the postcode lottery too – their eligibility rates are around the same as those in Stockport.
Why is this happening?
CCGs are supposed to follow a detailed national framework in deciding who is eligible for NHS CHC. But there is overwhelming evidence to show that the assessment process is deeply flawed. There is just too much wriggle room for assessors to downplay or dismiss what are obviously severe care needs. We know from our clients that CCGs in some areas will go further than others to avoid paying out. Often the residents in question are only weeks or days from death, completely incapacitated and sometimes unconscious.
What is happening where you live?
Maybe you have come across your own examples of the postcode lottery for NHS CHC.
If so call us on 0191 556 1078 or email us at firstname.lastname@example.org for a discussion about your case. Just Caring Legal is a solicitors’ firm specialising in NHS Continuing Healthcare Funding. As a digital law firm, we deal with CCGs all over the country on a daily basis. Contact us today and let us see if we can help.