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Equality watchdog forces U-turn on NHS organisations

The Spinal Injuries Association (SIA) welcomes the news today that 13 NHS Clinical Commissioning Groups (CCGs) have been forced by the Equality and Human Rights Commission (EHRC) into a U-turn and to review their NHS Continuing Healthcare (CHC) “settings of care” policies. The EHRC believes these to be unlawful and to contravene the human rights of severely disabled people, including spinal cord injured individuals.

In March 2018, the EHRC threatened to judicially review 13 CCGs over concerns about their CHC policies (covering life-sustaining care to some of the most disabled people in society) which place arbitrary financial caps on care provision and fail to adequately consider the specific needs of individual patients. Like the EHRC, SIA believes these policies constitute a serious breach of the Human Rights Act, the Public Sector Equality Duty and the Department of Health and Social Care’s own NHS CHC framework.  In light of the CCGs U-turn on these policies the EHRC has decided that no further legal action is currently required.  However they have committed to monitoring future CCG policies on this issue.

Dr Rupert Earl, Chair of the Spinal Injuries Association, said. “Today is a victory for people with complex healthcare needs. Our members have consistently told us harrowing accounts of the impact of these shameful policies on their health and well-being. These NHS organisations have further marginalized severely disabled people and denied them choice in their care.  This is entirely wrong, especially when with the right support they would be able to live at home with the families who love them and to lead fulfilled, productive lives.  That’s why we’ve been working closely with the EHRC to assist them to compel CCGs to meet their lawful obligations to spinal-cord injured individuals.”

Yet it would be far too premature to say that the battle for fair care has been won. Serious shortcomings in the delivery of NHS CHC care remain – as evidenced by the recent House of Commons Public Accounts Committee Report into NHS Continuing Healthcare. This identified widespread delays in assessment, variation in access and eligibility and arbitrary financial caps on what support is provided, as well as unjustified reductions in existing CHC care provision to unacceptable and potentially unsafe levels. We are continuing to actively engage with the Department of Health & Social Care, NHS England, and other decision makers to ensure the complex needs of those with a spinal cord injury are fully understood so that NHS CHC provides adequate levels of care for severely disabled people”.


NHS Continuing Healthcare (CHC) is a package of care provided outside hospitals, such as in people’s homes or in a care home, that is arranged and funded solely by the NHS through Clinical Commissioning Groups (CCGs). People must have significant health needs that goes above and beyond usual social care needs, such as help with washing or dressing.

It offers vital support for people with long-term and serious health conditions, including those with spinal cord injuries and provides long-term planned and funded care, thereby helping people to live independently in their homes, leading fulfilled lives.

Assessments of a person’s healthcare needs are made by the applicant’s local CCG who have a legal responsibility to provide funding to those assessed as eligible.  Meanwhile, NHS England has a responsibility to ensure that CCGs comply with the national framework for NHS CHC and to arrange independent reviews of ineligibility if needed.