Patients around the UK are facing a postcode lottery when it comes to continuing care on the NHS, our health investigators uncovered today. Have you been affected by the NHS postcode lottery like Gill and Carol?
Gill Jarvis was shocked to find herself footing a £96k per year care home bill at short notice. Her mum Jean – who has severe dementia – had lived in her care home for nine years and the NHS had been paying her care bills but all that suddenly stopped with little explanation when Jean’s local health board (Clinical Commissioning Group) reviewed her needs.
In another part of the country, Carol Rumens found herself in a similar situation when her husband Geoffrey’s continuing healthcare funding was stopped after eight years. Geoffrey has long-standing mental health problems and is physically very disabled and unable to care for himself.
Both Gill and Carol are clear that the person they love’s health has deteriorated, making the withdrawal of this funding even more hard to understand, and they’re not alone in feeling that they are victims of a continuing healthcare postcode lottery.
The NHS funds people who have the highest healthcare needs. Those assessed and deemed eligible have their full healthcare costs funded by the NHS – whether they live in their own home or in a care home, and whatever their financial situation. At a possible £1,000 plus a week, it’s a life-changing sum of money.
But despite a national framework for assessments, vulnerable people with complex conditions can be up to 25 times more likely to get their care costs covered depending on where they live, according to NHS continuing healthcare funding data.
South Reading, the Clinical Commissioning Group (CCG) area with the lowest level of people funded, paid care costs for 8.78 patients per 50K of the population, while Salford funded 220.38 people per 50K. Although different areas have different populations, these differences can’t be easily explained by demographic differences.
The inconsistencies affect people living in the same region too. In Stockport (31.76 per 50K), patients are almost seven times less likely to get the funding than those 10 miles away in Salford.
And it’s not just the funding that hits hard. Carol – herself an ex-nurse and health visitor – describes the emotional impact of fighting her husband’s case for funding. She said:
“This has nearly broken me. I go to meetings but it’s a foregone conclusion. This is not justice. CHC is meant to be based on need but his need has got worse. They ask my opinion but it’s not of interest to them even though I’m the one who knows him, and what triggers his mental health, best.”
A new national framework has now been published with implementation due on 1 October 2018. It will not change eligibility criteria, but aims to provide greater clarity, including for staff. But will it make the changes that are needed?