Funding system failing people with Continuing Healthcare needs

17 January 2018

The Public Accounts Committee report says Government must take steps to improve complex process beset with delays and poor-quality assessments.

Care compromised too often due to access to funding

NHS continuing healthcare (CHC) funding is intended to help some of the most vulnerable people in society, who have significant healthcare needs.

But too often people’s care is compromised because no one makes them aware of the funding available, or helps them to navigate the hugely complicated process for accessing funding.

Those people that are assessed spend too long waiting to find out if they are eligible for funding, and to receive the essential care that they need. About one-third of assessments in 2015–16 took longer than 28 days. In some cases people have died whilst waiting for a decision.

CCGs inconsistently interpreting assessment criteria

There is unacceptable variation between areas in the number of people assessed as eligible to receive CHC funding, ranging from 28 to 356 people per 50,000 population in 2015–16, caused partly by clinical commissioning groups (CCGs) interpreting the assessment criteria inconsistently.

The Department of Health and NHS England recognise that the system is not working as well as it should but are not doing enough to ensure CCGs are meeting their responsibilities, or to address the variation between areas in accessing essential funding.

NHS England wants CCGs to make £855 million of efficiency savings in CHC and NHS-funded nursing care spending by 2020–21, but it is not clear how they can do this without either increasing the threshold of those assessed as eligible, or by limiting the care packages available, both of which will ultimately put patient safety at risk.

Chair’s comment

Comment from Committee Chair, Meg Hillier MP:

“Conditions such as Alzheimer’s disease and multiple sclerosis have devastating effects on sufferers and their loved ones. Help with meeting the costs of ongoing care can make a critical difference to their quality of life.

It is therefore distressing to see the system intended to support such people fall short on so many fronts.

Oversight of CHC funding has been poor and NHS England’s demand that clinical commissioning groups make big efficiency savings will only add to the financial pressures on the frontline.

Government must step in now to ensure people with continuing healthcare needs are aware of the help available and that those eligible for funding receive essential care in a timely and consistent manner.”