pay for care

Some Patients Die While Waiting For a Decision on NHS Continuing Healthcare

You’re not alone! New report highlights how tens of thousands are failing to receive NHS care funding they are entitled to.

Are you trying to access NHS Continuing Healthcare funding for yourself or a relative – but getting nowhere? If so, you are far from alone. A new report by the government Public Accounts Committee says tens of thousands of people in England are having this vital care funding denied by the NHS. And it has criticised NHS England for failing to enable people to access NHS CHC funding, saying this put thousands at risk.

What is NHS Continuing Healthcare funding?

NHS CHC is available for people who have intense, complex or unpredictable care needs arising from a primary health need. They do not have to be a specific diagnosis. It may be the result of a severe illness such as Alzheimer’s, multiple sclerosis, chronic obstructive pulmonary disease, or Parkinson’s; and accident or a disability. NHS CHC is personal health and social care arranged and funded by NHS Clinical Commissioning Groups (CCGs). The care may be in a residential or nursing facility or at home. The funding is not means-tested – anyone can receive it regardless of savings, assets or income.

Some patients die while waiting for a decision on NHS Continuing Healthcare Funding.

In a report released this week, the Public Accounts Committee (PAC) slammed “inconsistency and delays” in assessing eligibility for NHS CHC. In some cases, it says, patients die while still waiting for this vital assistance.

NHS England has asked the local CCGs that administer NHS CHC to save £855 million from their CHC and nursing budgets by 2021. Which means even more people could miss out on this vital care funding. The report warned this would ultimately put patient safety at risk.

The report also criticises the postcode lottery that means the number of people receiving CHC funding varies from 28 per 100,000 in some parts of the country to 356 per 100,000 in others. It puts this down partly to the different ways CCGs are interpreting the rules governing eligibility. The chair of the committee Meg Hillier MP said this funding could make a “critical difference” to the quality of life of seriously debilitated patients.

She added that the demand for CCGs to make big efficiency savings would add to the financial pressures on the frontline. She said there should be “remedial action” against CCGs that fail to provide this vital lifeline for deserving applicants.

How can Just Caring Legal help?

Are you struggling to pay for care? Do you think you or a relative should be eligible for NHS CHC? If you are you should not be paying at all. Unfortunately there are many obstacles to overcome in accessing this vital funding. Just Caring Legal specialises in NHS CHC cases.

Legal Challenge To “Unsustainable” Council Care Fees Could Be A Game-Changer

Independent social care providers are waiting with baited breath for the outcome of the latest judicial review on council care fees. The case centres on the 2014 Care Act, which set high expectations for care of the most vulnerable in our society. It promised a vision for person-centred, wellbeing-based decision-making when meeting social care needs. This was to be based on a dialogue between public sector commissioners, care providers and service users and their families. The aim was to create a sustainable market for high quality affordable care.

Unrealistic local authority care fees threaten the whole care system.

However, the funding crisis afflicting local government and our NHS is threatening to wipe out this picture. In many cases, local authorities and NHS Clinical Commissioning Groups are making decisions about care based on what they claim dwindling budgets allow. The decisions should be based upon what is fair, adequate and sustainable. As a result, in many areas local care systems are on the brink of collapse. Providers find their business models unworkable because of unrealistically low payments. However, this could change.

So Care England launched Judicial Review proceedings against Essex County Council.

In October 2016, Care England, a national membership body for care homes, declared “Enough is enough”. Care England sought – and received – leave to launch Judicial Review proceedings against Essex County Council. It argues the fee rates Essex offers independent care home providers breach its duties under the 2014 Care Act. These also include a duty to maintain a sustainable market for care. By setting rates “significantly below” the costs of providing care, Care England argues Essex is putting the whole market at risk of collapse. If the courts agree, this could open the floodgates to legal challenges in other localities.

The Essex Judicial Review challenges a New Contract for care placements that took effect on 1 February 2016. According to Care England, a majority of the county’s care providers did not sign up to the New Contract. They claim this was because the rates were unsustainable. The maximum fee levels Essex offered were £401.31 to £538.37 per week for residential care and £420.91 to £577.29 for nursing care. It offered these rates without any enquiry into providers’ actual costs of care. In the case of a 50 bedded care home, Care England calculated the level of underfunding is of an order that would exceed £400,000 per annum in the case of residential care.

This case could set a powerful precedent for many more claims.

It is a story that will be familiar to service users and care providers all over the country. Unsustainably low local authority care rates mean many homes have to turn down publicly funded residents. In other cases, local authorities and even some NHS CHCs are wrongly relying on third-party top up payments to subsidise care.

As a legal firm specialising in the recovery of care fees, Just Caring Legal helps families who are unfairly paying the price for this inadequate funding. We work closely with independent care providers to ensure residents get all the care funding they are entitled to.

Which is why if Care England’s judicial review succeeds, it will pave the way for many more claims. Providers would seek to secure more sustainable rates for care, based on what would be a powerful legal precedent. Additionally, it could change how social care is treated in the UK.

Watch this space!

If you believe you or a relative may be entitled to NHS Continuing Healthcare funding, contact us today.

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