/ Health

Why NHS complex care funding could depend on where you live

Elderly couple in care home

We’ve found a postcode lottery in how the NHS pays for the care of people with complex medical needs, such as care homes. Getting funding for ongoing care shouldn’t depend on where you live.

A friend of mine has been struggling to get the NHS to pay her dad’s care home fees. He has severe dementia and very complex medical needs, so it seems he should qualify for NHS continuing healthcare funding. This would mean all his care home costs would be funded, meaning as much as £50,000 a year is at stake.

The area he lives in is pretty low down the list for the number of people the NHS funds per 50,000. But what really shocked me is how much the number varies across England

In Salford, 144.6 per 50,000 people get the funding, but it’s just 27.7 people per 50,000 in Oldham which is down the road. And in South Reading it’s just 11.4 people per 50,000.

These anomalies can’t easily be explained by differences in the population, as the figures are adjusted to reflect these.

Care funding problems

NHS care funding We last looked in detail at these numbers back in 2011 and we saw a pretty similar postcode lottery, although the overall number receiving funding has risen slightly. And in 2012 a new national framework was brought in to tackle the variation in funding across the country. Yet, the problem still exists.

Experts tell me that the numbers don’t tell the whole story either. For example, we don’t know how many people lose this funding when their needs are reviewed or how many people get part, rather than all, of their care funded by the NHS.

We’re also talking about the sickest, most vulnerable people here, and I know from experience that the last thing they and their families need is to spend precious time haggling over assessments and who should be getting what.

The Government needs to do more to make sure the system in England works fairly and consistently for patients whatever their postcode.

Do you have a relative who’s experienced the postcode lottery for NHS care funding first hand?


I recall a parliamentary debate on this very subject a while ago and the general opinion from the Labour Benches was that higher funding for care was directed to where it was most needed.

As North Eastern areas are mainly Labour controlled and appear to contain the highest UK unemployment figures at 10.3% as opposed to the South East [excluding London] at 5.3%, this could account for the extra funding needed for care in North Eastern regions, although I am certain there must be a host of other reasons for this disparity.

I have been fighting this for years as can now see it happening to me caused by policies & procedures of NHS
.My Mother died 3 years ago it is still ongoing . When they go into care the area in which Care home exists takes over or not the funding allowing those on remits to maladministrate the system giving unfair hearing with the political & Complaints system ignoring .
The Doctors are employed for whole home & suspect often miss complications as ignore history .Suspect Mother had complications of polymyalgia rheumatica.
It relates to the LAs as fundholders maladministrating the social services, having Reviews not allowing you [ myself ] to speak at Meeting with the lawyers leaving the case in limbo .There has now been 5.Both my late Parents & myself have lived on boundaries unable to access the appropriate diagnosis, treatment & care to point in my case of near fatal cardiac arrest [ died 3x] after weekly GP visits recording classic heart symptons as mental on online Medical record to cover up .This is still happening.

Gerald says:
1 December 2014

This started as long ago as 1996 when the goverment of the (Conservative) took the funding from the Dept.of Health and gave it to Local Authorities and Area Health Authorities. Funding for Residential Care has always been “Means Tested ” the reason given for this at the time was that going into Res.Care was a personal choice and not one of necessity,.whereas as Nursing Home was considered and extension of Hospital and in many subsequent instances replaced to old Geariatric wards and funding was dealt with by the Area Health Authorities and was therefore deemed”Free” under the NHS Act. What changed? well again the change happened over many years and suprise, suprise it is down to Politics and has absolutly nothing to do with common sense or patient needs or post codes, its all about keeping the people in Hospital where, according to some, they ought to be. Much ado has been made by the Public Sector about how bad the qualty of the so called Profit Mad Private Sector is and many smear campaigns have been waged. The Public have not been swayed and have continually chosen tthe private sector to be their provider of choice .By the intruduction of trumpted up criteriors NHS funding has been waylaid, diverted and otherwise high jacked.
One has only to look at Which’s own conversation on this topic to see the distress and heart ache that this is causingto the General Public never mind the headaches for the poor staff in the NHS who have to sort out the bed blocking,staff shortages etc., when will the NHS AND LOCAL GOVERNEMENT be free of political Dogma and be allowed to be “free to all “” ????.I am sure many will find my comments hard to accept but all I can say is reality is stranger than fiction it has taken me nearly 20 years to make some sense of it and I am not suprised if people find it difficult to understand.
One only has to look at the mess in other areas of the Public Sector Care Provisioning to see the effect of fanatical Political Involvement (Mid Staffs Hospital, Child care all around the Country etc.)