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NHS funding is a postcode lottery – have you been affected?

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.

Care costs

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.

Emotional impact

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?

Comments

While on the subject of the NHS I hope all those relying on it hope for a Brexit WITH a deal.

Taken from the Guardian-

British nationals who have retired to EU countries including Spain and France will no longer have their healthcare covered by the NHS in the event of no Brexit deal, the government has said.

The confirmation will come as a blow to around 190,000 British citizens retired in the EU in places such as the Spanish Costas, Provence in France and Tuscany in Italy.

Brexit weekly briefing: MPs prepare to make do or amend
Read more
It could also add to the burden on the NHS if pensioners believe they have no option but to return to the UK for treatment. The government has previously admitted it is cheaper to pay Spain and France to look after British nationals than have them fly home.

Currently pensioners can get treatment reimbursed by the NHS under an EU-wide set of reciprocal arrangements.

“It is another example of how those advocating no deal are playing with the lives of British citizens living in other EU countries,” said Colin Yeo, an immigration lawyer and freedom of movement campaigner. “Many of these politicians and pundits probably haven’t bothered to find out how their policies would actually affect such people.”

Pensioners who have paid in to the national insurance system for the qualifying number of years benefit from the “S1” reciprocal healthcare rules if they retire in EU/EEA countries or Switzerland.

An S1 certificate is available to anyone in receipt of a state pension, and to some workers who are sent overseas on a temporary basis by their UK employers.

In a little-publicised no-deal technical notice published this week, the UK government said: “An S1 certificate helps you and your dependents access healthcare in the EU/EEA country where you live. If you have an S1 certificate, it will be valid until 29 March 2019. After this date, the certificate may not be valid, depending on decisions by member states.” -end quote.

I hope things turn out differently .