Supplementary memorandum by the Parliamentary
and Health Service Ombudsman (CC 23A)
I write following the Health Select Committee
meeting of 17 March 2005, which my Deputy, Trish Longdon, attended,
along with Colin Houghton, Head of the Continuing Care Team. Once
again, I would like to apologise for not being able to appear
before the Committee personally. Thank you for your understanding
on this issue.
I believe that the Committee requested some
further information and I am pleased to respond.
You asked us to provide you with some additional
information on the regional spread of the continuing care cases
which we are currently investigating.
I attach a breakdown by Strategic Health Authority
(SHA) of the cases in hand. You will see that all SHAs are included
and that the complaints against each which we are currently dealing
with range from one to 92. However, as I know my Deputy pointed
out, it is difficult to draw conclusions from this data. My office
is demand led; the absence of complaints cannot be taken to suggest
good practice, or vice versa. The number of complaints may, for
example, simply reflect local publicity or an active advocacy
service.
Below, I cover four examples of good practice
in different bodies. You also sought examples of good practice
in handling applications for full NHS continuing care funding.
These are:
GREATER MANCHESTER
SHA
— strenuous efforts to obtain all available
evidence;
— good level of relative/carer participation
encouraged;
— full list of panel members considering
applications; and
— detailed explanation for decisions.
AVON, GLOUCESTERSHIRE
& WILTSHIRE SHA
— clear, easy to understand process;
— carers/relatives involved at all
stages;
— excellent leaflet and policy documents:
available on their web-site;
— continuing care leads at the SHA
have firm grip on, and understanding of, purpose and procedures,
and have taken full ownership of the entire process; and
— very robust appeal process: prepared
to overturn PCT decisions on the merits of each case.
NORTH NORFOLK
PCT
— full consideration of all time-frames
for all patients.
SOUTH WEST
PENINSULA SHA
— appeal panel invites carers/relatives
to attend; and
— detailed records of panel discussions
kept.
I would also like to take the opportunity to
clarify one of Colin Houghton's answers to the Committee. When
asked if he thought there should be one assessment tool, he agreed.
I would like to make it clear that he should have said that there
should be a single set of assessment tools, as set out
in my retrospective report on continuing care. I am sorry if this
was not clear during the evidence session.
Finally, there was an exchange about the reliability
of information given to me by the Department of Health in late
2003 and early 2004. To avoid any confusion, I refer to the statement
I made in my recent report (page 4, paragraph 5):
"Although we had indicated in our report
in February 2003 that `significant numbers of people and sums
of money are likely to be involved', the large scale of applications
for retrospective review and restitution was unexpected. In view
of this, the Department of Health extended the deadline for dealing
with them to 31 March 2004. We passed on to the Department of
Health early concerns that we had heard from NHS bodies about
difficulties in meeting both the December and March deadlines.
However, on both occasions the Department assured us that their
information showed the targets would be met and we passed on these
assurances to complainants, their representatives and Members
of Parliament. It became evident that the Department's information
was unreliable. It was very disappointing that in September 2004
the Parliamentary Under Secretary of State for Community reported
that only 57% of the retrospective reviews (6,644 out of 11,655)
had been completed by the extended deadline of the end of March
2004. This prompted a flood of complaints to us—mainly from
frail, elderly people who were themselves carers or from their
relatives—about delays in receiving a decision."
March 2005
IN HAND CONTINUING CARE CASES
| Avon, Gloucestershire and Wiltshire Strategic Health Authority
| 30 |
| Bedfordshire and Hertfordshire Strategic Health Authority
| 13 |
| Birmingham and The Black Country Strategic Health Authority
| 21 |
| Cheshire and Merseyside Strategic Health Authority
| 92 |
| County Durham and Tees Valley Strategic Health Authority
| 5 |
| Cumbria and Lancashire Strategic Health Authority
| 42 |
| Dorset and Somerset Strategic Health Authority
| 43 |
| Essex Strategic Health Authority | 27
|
| Greater Manchester Strategic Health Authority
| 33 |
| Hampshire and Isle of Wight Strategic Health Authority
| 9 |
| Kent and Medway Strategic Health Authority |
19 |
| Leicestershire, Northampton and Rutland Strategic Health Authority
| 18 |
| Norfolk, Suffolk and Cambridgeshire Strategic Health Authority
| 5 |
| North and East Yorkshire and Northern Lincolnshire Strategic Health Authority
| 22 |
| North Central London Strategic Health Authority
| 10 |
| North East London Strategic Health Authority
| 21 |
| North West London Strategic Health Authority
| 13 |
| Northumberland, Tyne and Wear Strategic Health Authority
| 12 |
| Shropshire and Staffordshire Strategic Health Authority
| 22 |
| South East London Strategic Health Authority
| 9 |
| South West London Strategic Health Authority
| 9 |
| South West Peninsula Strategic Health Authority
| 39 |
| South Yorkshire Strategic Health Authority |
16 |
| Surrey and Sussex Strategic Health Authority
| 29 |
| Thames Valley Strategic Health Authority |
13 |
| Trent Strategic Health Authority | 52
|
| West Midlands South Strategic Health Authority
| 1 |
| West Yorkshire Strategic Health Authority |
21 |
| |
|
