What do we really know about the experiences of those going through NHS Continuing Healthcare eligibility assessments?
If someone is eligible for NHS Continuing Healthcare this should cover both their health and social care costs. If the NHS Continuing Healthcare assessment finds they are not eligible, the individual may have to pay some or all of their social care costs. However, this depends upon their assets, savings and income.
At Just Caring Legal, we hear anecdotal evidence every day about how the assessment process is working – and not working – for people. But what do the statistics tell us? Sadly, not enough.
NHS England published its latest data this month, covering April to June 2017. It told us the total number of people receiving assessments for NHS Continuing Healthcare was 35,654. Of these, 14,668 were via the Standard NHS Continuing Healthcare assessment route and 20,986 via the Fast Track assessment route. Less than a third (31%) of standard assessments resulted in eligibility. Yet, most applicants would have undergone an initial screening process to assess their likelihood of success before a full assessment.
On the other hand, nearly all (99%) of those receiving Fast Track assessments were successful. Fast Track assessments are designed for those who require end of life care.
What the NHS England figures can’t tell us is why there are such huge variations nationwide in both the number of assessments and the proportion of applicants qualifying for NHS Continuing Healthcare funding.
How different local bodies are applying national guidelines.
The National Audit Office found that in 2015-16, the proportion of people referred for an assessment who were subsequently deemed eligible for NHS Continuing Healthcare funding ranged from 41% in some local Clinical Commissioning Groups, to 86% in others.
NHS England itself admits it cannot explain the variation in so-called “conversion rates”. There must be significant differences in the way local bodies are applying the national guidelines on NHS Continuing Healthcare assessments.
Where is the meaningful data that might help shed light on this? It simply isn’t there. The independent Continuing Healthcare Alliance put it in a nutshell:
“At the moment…we know nothing about all of those who were unsuccessful. We don’t know how long they waited for an assessment, why they were unsuccessful, or if they appealed. Healthcare professionals have huge demands on their time, but it is essential that accurate information around NHS Continuing Healthcare is recorded so the system can be improved, and problematic areas can be tackled.”
We need to fill in these blanks so we can make sure the NHS Continuing Healthcare system works justly and efficiently for everyone. Their postcode should not be a factor.
We find that if our client’s seek our help earlier in the process, there is usually a greater chance of success in a shorter period of time. If you have queries about your family’s situation then contact us today.