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Statement: National Audit Office Investigation into NHS continuing healthcare funding

The light shone by the National Audit Office in its report published yesterday – Investigation into NHS continuing healthcare funding – provides much-needed scrutiny of the funding of long-term care for seriously disabled people. It is our view that the personal value of such care to the individual and society needs to be considered as much as the financial cost to the Exchequer.

The report provides an authoritative and independent contribution to what our members and callers to our advice line have been telling us for some time; that whilst a well planned and funded care package can support an independent and fulfilled life for people with the most serious disabilities, for too many people NHS Continuing Healthcare funding (CHC) is instead a depressing tale of widespread variation in access and eligibility, delays in assessment and arbitrary caps on what is funded. In practical terms, we have heard of cuts to the size of CHC funded care packages that are in some cases reducing care provision to unacceptable standards.

There are incidents of overnight care being removed and we have started to receive examples of people who have been threatened with a move out of their own home and into residential care due to budgetary constraints. More widely, the decades-long march toward integration of people with disabilities playing an active role in society, where they can, is being eroded as people are denied packages of care that foster independent and fulfilling lives.

The report also highlights an increase in demand for NHS CHC funding as well as NHS England’s plans to save £855 million through reducing both the overall cost of care  as well as administrative assessment costs. Whilst the funds for providing care in someone’s home cannot be limitless, decisions must consider a person’s desire to live an independent and fulfilled life at home with their family. It is difficult to see how efficiency targets can be met without either reducing the number of people eligible for NHS CHC, reducing the amount of care people eligible for NHS CHC received or a combination of the two.

We are calling today for further scrutiny by the Public Accounts Committee of the entire CHC process and the impact the current system has on those seeking support, as well as a considered response by NHS England into the serious deficiencies uncovered in the report. The patient’s needs must be at the centre of decision making.

There needs to be a reduction in regional variation of assessments and awards – a postcode lottery of care –  that the report amply highlights that is not a race to the bottom, greater enforcement by NHS England to ensure lawful decision making that is in the spirit and letter of the national framework used by the CCGs, but above all a system that genuinely engages with people to provide the independence, support and care they deserve and need.

Read more about our Cuts to Care campaign here.