23 June 2006
The government has pledged to eliminate the 'postcode lottery' in NHS funding for care home residents through the long-awaited introduction of a single national framework.
But social care experts have told Public Finance they are concerned that the government's draft framework for 'continuing health care' – issued for consultation on June 19 – provides no new funding and gives primary care trusts too much discretion to continue restricting funding.
'If they're going to be reducing administration and red tape – which we welcome – then it would have been good if they could reinvest the savings to pay for a higher level of nursing care,' said Pauline Thompson, head of care finance at Age Concern.
The new framework proposes an initial screening process in which people leaving hospital would be screened against national – rather than local – criteria to see if they qualified for NHS continuing care.
If they qualified, all their care home costs – including 'personal care' and accommodation costs – would be covered by the NHS.
Thompson told PF that it was possible that systematic screening would lead to an increase in the number of people moving from means-tested care to free NHS care from 21,000 to 34,000.
Although the Department of Health estimates the cost increase at £110m, it says £70m of this was 'unavoidable', due to current legal challenges to local criteria.
People who do not qualify for full continuing care funding might still qualify for NHS funds to cover the cost of care from a registered nurse in a care home, but not their personal or accommodation costs.
At present, such cases are grouped into three 'bands' of funding, related to the intensity of nursing required. The framework proposes just one band, funded at the average national cost of £97 per week.
But Tim Hind, social care adviser for the Local Government Association, told PF: 'A single band is a good thing, but they've also left some discretion to vary in that band.
'A cash-strapped PCT might lower the funding.'
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