Postcode lottery for NHS Continuing Healthcare continues

15 | 11 | 2011

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Large care home costs continue to be wrongly paid by the elderly in many areas due to inconsistencies in implementing the national framework for continuing care.

The latest Department of Health figures* highlight huge ongoing local variations; in some areas, the number of people eligible has dropped considerably over the past two years.

Hugh James’ Nursing Care team has been contacted by people whose NHS Continuing Healthcare package has been reviewed and funding removed even though there has been no change in the person's health needs.

Those people now considered ineligible will have to fund the care themselves or have it paid by the council, increasing pressures on adult care departments. This will inevitably lead to disputes between councils and primary care trusts and to families challenging decisions.

Concern about the situation caused the Department of Health to remind the NHS in July of the national process for determining eligibility for NHS Continuing Healthcare and that any attempts to make efficiency savings in continuing care should be “undertaken within the appropriate legal parameters for determining eligibility”.

The recent Department of Health figures showed an overall increase in the number of people eligible in the last quarter from 53,466 to 55,499. However, the figures reveal that the number of people receiving continuing care per 50,000 population ranged from 16 in Berkshire West PCT to 136 in Darlington PCT, the average being 54 per 50,000 population.

The figures also showed a huge reduction in some areas; for example, Bournemouth and Poole PCT fell from 112.4 in the first quarter of 2010/11 to 36.7 in the second quarter of 2011/12.

Lisa Morgan, Partner at Hugh James solicitors states: ‘The National Framework was introduced to end the postcode lottery in England. However a review of these figures shows that it still remains.’

‘It is very worrying that funding is being removed. In most of the cases I have seen, funding has been withdrawn unfairly as the individual health needs have not significantly changed. This will simply result in increase use of NHS resources and cost in trying to defend unreasonable decisions’

Hugh James are the leading national experts in recovery of wrongly paid care home fees. Our nursing care legal specialists have successfully recovered over £20 million for families across the UK.

If you or a relative are in a nursing or care home because of physical or mental health needs, you may be paying fees that should have been funded by the NHS. Contact us today to find out if you or a relative are eligible for NHS Continuing Healthcare and reimbursement of care home fees.

* You can read the full report from the Department of Health here:  http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_103162

ContactLisa Morgan

Lisa Morgan

Partner

E lisa.morgan@hughjames.com

T 029 2022 4871


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