PCTs ignoring new rules on personal care provision

4 Oct 07
The pledge to end the 'postcode lottery' in who gets free social care might not bear fruit because primary care trusts are ignoring new guidance from the Department of Health, Public Finance has been told.

05 October 2007

The pledge to end the 'postcode lottery' in who gets free social care might not bear fruit because primary care trusts are ignoring new guidance from the Department of Health, Public Finance has been told.

New national guidance to determine who is sick and disabled enough to qualify for free, NHS-funded personal care such as washing and dressing came into effect on October 1.

When the guidance was published in June, care minister Ivan Lewis said it would put an end to the 'running sore' of wide variations in the way PCTs assessed eligibility, leaving thousands to pay for themselves or to seek council-funded services.

But Jeff Jerome, joint chair of the Association of Directors of Adult Social Services' disability committee, told PF that many PCTs were ignoring the new guidance.

'Messages have gone out from the Department of Health, but I'm not sure PCTs have been told firmly and absolutely enough that they need to review their current arrangements. But they have to, or else they won't be acting lawfully,' he said.

In June, the DoH estimated that the new guidance would lead to a 32% increase in the numbers qualifying for so-called NHS Continuing Care, which would cost PCTs an extra £220m a year from their existing allocations.

But Jerome told PF that despite the three-month formal lead-in to the implementation of the guidance and extensive consultation time before that, he did not see enough evidence of PCTs proactively changing their policies.

'This has been a very budget-driven process in the past, so the question is: are PCTs still looking at their budgets to try to avoid it? I will be very surprised if many PCTs will have gone to their local authorities and said “we need to reassess all our arrangements”, because for the majority that will mean more expense,' said Jerome.

Earlier this year Age Concern published figures revealing the extent of variation in the way PCTs assessed Continuing Care eligibility. As of March 2007, Derby City PCT provided Continuing Care to just 0.26 people per 10,000 population while Harrow PCT provided it to 42 people per 10,000 population.

A September 6 board document from Derby City PCT shows that although it acknowledged that the new criteria would require it to provide free care to more people, it had still not quantified how many or at what cost. Training was not due to start until September 13.

By contrast Suffolk PCT – which had the second lowest eligibility rate at 0.96 per 10,000 – has estimated a four-fold increase in their numbers from 57 to 220, increasing its spending from £2.4m to £8.6m.

PFoct2007

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