In January, following an inquiry to which we were invited to give expert evidence, the Public Accounts Committee (PAC) published their frank assessment of the state of the Continuing Healthcare (CHC) system. In it they highlighted five areas where the system is falling short:

1. delays in assessments
2. awareness of the funding
3. the postcode lottery of eligibility
4. inconsistent compliance to the national guidelines
5. unclear savings targets

Alongside each area, the PAC made recommendations for improvement – asking the Department of Health and NHS England to report back by April 2018 in most cases.

Response from the Government

The Government’s response to these recommendations were published in Treasury minutes (pages 14-16) in March 2018. They agreed with all of the PAC’s recommendations.

In response to points 1 and 4 it was stated that an assurance mechanism is already in place to hold Clinical Commissioning Groups (CCGs) to account when they don’t follow the guidelines or meet targets.

As part of the response to points 2, 3 and 4 it was stated that fact-finding work will take place, or is intended, to understand the current challenges.

In response to point 5 a shopping list of notional efficiency opportunities that local commissioners might consider was presented.

What we think

Beacon’s Managing Director, Dan Harbour, said: “We wholeheartedly support the recommendations made by the PAC for improved scrutiny, accountability and consistency of NHS CHC across England. We also share their concerns that the proposed £855 million of savings in this area by 2020 will result in fewer people being eligible for CHC or funding cuts that leave more of the most vulnerable people in society without adequate care.

“The Government’s response to these recommendations cannot be described as heart-warming. The reassurance that a mechanism is already in place to hold non-compliant CCGs to account falls rather short. We’ve seen no evidence of this, and – as the National Audit Office report in 2017 highlighted – huge inconsistencies remain across the CHC process.

“We are pleased to read that a national workforce programme of training has begun, and that methods to identify CCGs at the extremes of practice are being developed. We look forward to the outcomes of both activities.

“Finally, we are not reassured about the required cost savings. While the Government has provided some insight into where they expect cuts to occur, they have generalised nearly 30% of the savings with the phrase ‘locally delivered improvement initiatives’. Only time will tell what this means in practice for many thousands of vulnerable people around the country.”

Do you need our help?

Beacon CHC is a social enterprise providing ethical, expert and affordable help to help trying to navigate the maze of NHS Continuing Healthcare. For over 13 years, our team of specialist caseworkers have won over £8 million in restitution for our clients, with a success rate of over 70% in cases brought to appeal.

We’re proud that, in addition to our paid-for casework, we provide free and independent help to hundreds of patients and families every week through the Information and Advice Service and free Navigational Toolkit.

If you have questions about any aspect of NHS CHC, call us on 0345 548 0300