‘Vulnerable patients’ face ongoing caps to care funding

Commissioners have been allowed to continue applying cost caps to the more than £3bn of NHS Continuing Healthcare claims as long as they follow new new government rules.

The Department of Health and Social Care’s new framework, developed in partnership with NHS England, does not explicitly ban cost caps as long as commissioners take into account an individual’s needs when they do so.

CHC pays for ongoing care for adults, described by the DHSC as ”some of the most vulnerable in our society” and who are assessed as having a primary medical care need in a community setting. It is arranged and funded solely by the NHS and in 2015-16 cost the service approximately £3.1bn.

HSJ has previously reported that 37 CCGs were introducing policies to cap the cost of providing NHS Continuing Healthcare support in a person’s home if the spend would be significantly higher than a residential care placement. Last year the Equality and Human Rights Commission said it was investigating concerns the policies would be “likely to breach individual equality and human rights.”

The new guidance, published yesterday, said a commissioner “must not set arbitrary limits on care at home packages if this does not represent a personalised approach or an accurate appraisal of the cost” of meeting an individual needs.

Article from HSJ, 2 March 2018