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The Government has been urged by a new Public Accounts Committee report to take action to stop potentially thousands of people from missing out on NHS Continuing Healthcare funding. The report has highlighted several serious concerns, all of which have been well documented by those who have experienced of the system in the past.

There is a new target implementation date for changes to be made to help people to be able to access NHS Continuing Healthcare. That target is set for this summer (2018), but whether it is met, and whether the changes have any impact remains to be seen.

The new Public Accounts Committee report comes to several worrying conclusions. These findings have been repeated by the Public Accounts Committee as they were first raised in its initial NHS Continuing Healthcare report at the start of 2018.

“Too many people are waiting too long to find out if they are eligible for CHC, and to receive the essential care that they need.”

For a cost-effective system, and one that minimises the worry and anxiety for patients, we need NHS Counting Healthcare to be implemented (where appropriate) efficiently, quickly and smoothly. This is not happening in many cases and so patients are left to pay for their care when they may be entitled to NHS Continuing Healthcare simply because the process is too slow.

“Some patients are not receiving the care that they are entitled to because they are not made aware of the funding available, or because the system is too difficult for them to navigate.”

At the start of the year, the Public Accounts Committee warned that 78% of healthcare professionals believed that NHS Continuing Healthcare was difficult for patients and their families to navigate. People should not be blocked from receiving funding they are entitled to because the system is too complex and convoluted.

“Patients’ likelihood of getting CHC funding depends too much on local interpretation of assessment criteria, due to poor quality assessment tools and inadequate training.”

While a multi-disciplinary team (MDT) should comprise of one social care and one health care specialist, often the people on the team do not understand the complex needs or specific condition that a patient may have. This means that the true and full scope of a person’s needs may not be taken properly into account. This can severely impact a patient’s outcome in the process.

In addition, the National Framework is a guideline but CCG’s are free to implement it as they see as appropriate. This means that there can be huge variation between different localities as to where is more likely to award NHS CHC. Care decisions should not be a postcode lottery.

“NHS England is not adequately carrying out its responsibility to ensure CCGs are complying with the legal requirement to provide CHC to those that are eligible.”

This is perhaps the most worrying conclusion and could be partially responsible as to why so many CCGs vary in how likely they are to find people eligible for NHS Continuing Healthcare. There has to be a commitment to ensuring that those who meet the criteria to qualify for NHS Continuing Healthcare are granted it. Otherwise, the system is deeply unfair.

“It is not clear how CCGs can make £855 million in efficiency savings by 2020−21 without restricting access to care, either by increasing eligibility thresholds or by limiting the care packages available.”

We were warned about this too in the report earlier this year and this warning has been repeated. This could mean that there are substantial changes to NHS Continuing Healthcare if funding is not made available to ensure that free care funding is sustainable if you have a ‘primary health need’.

Our clients face these issues everyday and echo the comments outlined above. When will we see a positive change?

If you think you may be entitled to NHS Continuing Healthcare and/or you have been refused NHS Continuing Healthcare funding, please contact Rosalind Hughes at Just Caring Legal today. Call us now on 0191 556 1078 or email us at [email protected]

Why there are fears about the NHS Continuing Healthcare squeeze.

The Guardian has reported that many people receiving NHS Continuing Healthcare are living in fear of losing their independence and being placed in a care home due to the squeeze on what clinical commissioning groups are paying towards care.

The Government has placed increasing pressure on services to make savings. Earlier this year, the Public Accounts Committee reported that it would be difficult for NHS Continuing Healthcare to remain the same due to the expected increase in demand, and without extra funding there was no way that the care packages could remain fully funded or that there wouldn’t be some adjustment to eligibility.

The Guardian report makes for difficult reading. Many people have gained independence due to NHS Continuing Healthcare. It has enabled people (who often have complex needs) to remain at home and be able to pursue their interests in life. However, for some, this is all coming under pressure.

One story reported was of Lucy Watts, who has osteoporosis but was able to live at home thanks to NHS Continuing Healthcare. However, when her mother was diagnosed with a brain tumour, Lucy turned to her clinical commissioning group as she would need extra support while her mother received treatment. Lucy was told that the only option was to go into a care home and, more horrifyingly, once she took up residence in the care home she would not be able to go out (even to attend her own medical appointments). The CCG did back down after Lucy threatened legal action, but it should never have reached that point. NHS Continuing Healthcare is designed to look after people at home, in residential settings, hospitals and/or care homes.

Lucy though has insisted that she believes that her independence was seen as “too costly” and that to save money, the CCG was pushing to get her into a care home. This is not just an issue specific to NHS Continuing Healthcare. Last year, the European Court of Human Rights warned that because of cost-cutting, disabled people were at risk of being “interned” in care homes. Those in receipt of NHS Continuing Healthcare may be far more at risk of such a situation, because their health needs can be quite complex, particularly for those who have dementia, MS, mobility issues and/or severe cognitive impairments.

What this means for people receiving NHS Continuing Healthcare.

While this is an issue that disabled people are reporting without support, it is also an issue for those who are specifically in receipt of NHS Continuing Healthcare. A Money Mail investigation earlier this year found that around 21,000 people were being reassessed each year, and while reassessments must take place, some reported that they were losing out on their care package despite the fact that their needs had actually increased.

This all presents a worrying picture about what people going through the NHS Continuing Healthcare process face. The legislation is clear that fully funded care must be given to those deemed to have a primary health need. Yet, the backdrop of cuts has risked putting a strain on services to which people have a right to.

What you can do to protect your NHS Continuing Healthcare package.

Unfortunately, Lucy’s story isn’t uncommon. At Just Caring Legal, I hear similar stories and it can be incredibly distressing for people to fear that they are about to lose a care package that they rely upon every single day. However, as in Lucy’s case, taking legal action if you find your funding is under pressure can make CCGs reconsider. It can be the best way to protect your care. Sometimes, there simply aren’t the grounds for people to lose funding, but they find it under threat anyway as they just don’t have the resources to be able to fight the decision within the system. This is why having an advocate who has expert medio-legal knowledge can make all of the difference in such cases.

If you’re worried that your NHS Continuing Healthcare package may be under threat, or that you are not getting the funding or care that you are entitled to then contact Rosalind Hughes at Just Caring Today. You can call now on 0191 556 1078 or email Rosalind at [email protected].