2 NHS Continuing Care - key problems
and issues
19. In its written evidence, Citizens Advice argued
that "decision making around eligibility for continuing care
continues to be one of the least satisfactory areas of NHS practice."
In its view this stems from the complexity of the policy itself,
which has proved "difficult to understand and to administer."
The organisation went on to emphasize the human cost of poor judgement
in this area:
[The complexity of the policy] has resulted in
poor decision-making by health professionals and lack of information
for patients, leaving many confused and frustrated. Yet these
decisions, which can be very marginal, have huge financial implications
for patients and their families, often running into hundreds of
thousands of pounds.[17]
20. The development of "a national consistent
approach to assessment for fully funded NHS care" was announced
by the Government in December 2004.[18]
In its statement, the Government said that the Department would
work with SHAs to build on all the work to date done in this area.
However, the wealth of evidence we have received in the course
of this inquiry from organisations representing patients, carers
and health and social care professionals convinces us that the
in the course of this review, the Government must take account
of the views of patients, carers and professionals as well as
NHS bodies.
21. In
its forthcoming review of the system of NHS continuing care funding,
it is vital that the Government draws on the views and experiences
not only of NHS bodies and local authorities, but also of patients,
carers and professionals. We therefore recommend that the Government's
review of continuing care funding arrangements take the form
of a full, formal public consultation, in line with Cabinet Office
recommendations.
22. In examining the problems and issues surrounding
NHS continuing care, we begin by considering the separation of
health and social care systems, which necessitates a whole range
of distinctions between personal, nursing and health care which
are largely artificial and impossible to administer, and which,
arguably, underpin all the current difficulties in funding continuing
care. We give detailed consideration to problems both with the
continuing care eligibility criteria themselves and with the processes
in place for applying the criteria through local assessment. We
then discuss the retrospective review process, before finally
examining a number of wider systemic problems with both continuing
care and RNCC funding, which are fundamental to the provision
of high quality continuing health and nursing care.
17 CC15 Back
18
HC Deb, 9 December 2004, col 108 WS Back
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