Select committee inquiry

Investigation into NHS continuing healthcare funding

Closed

Public Accounts Committee · Opened 19 October 2017 · Closed 19 October 2017

What the inquiry looked at

“NHS continuing healthcare funding (CHC) is a package of care provided outside of hospital that is arranged and funded solely by the NHS for those 18 or older who have significant ongoing healthcare needs. In 2015-16, almost 160,000 people received, or were assessed as eligible for, CHC funding in the year, at a cost of £3.1 billion. If someone is assessed as not eligible for CHC funding, they may still be entitled to other health and social care services, some of which the individual may have to pay for. The National Audit Office (NAO) published an investigation into CHC in July, in which the NAO identified problems with the CHC assessment process as the current process both raises people’s expectations over whether they will receive funding, as well as failing to make the best use of assessment staff. It was also found that while in most cases eligibility decisions should be made within 28 days, often people are waiting longer. Delays in the eligibility process are of concern as they can cause both emotional distress to patients as well as financial pressures. The number of people receiving CHC funding is rising and as such, the funding is causing considerable pressure on Clinical Commissioning Groups (CCGs). The NAO investigation also found that there is significant variation between CCGs in both the number and proportion of people assessed as eligible for CHC; this may be due to differences in the way CCGs are interpreting the national framework to assess whether people are eligible for CHC, due to its complexity. The Public Accounts Committee will consider developments made on CHC since July and question representatives from the Department of Health and NHS England to ask them what is being done to improve the assessment process and how NHS England’s efficiency plan is affecting the spending of CCGs and the delivery of CHC. The Committee will also hear from representatives from the Continuing Healthcare Alliance, the Spinal Injuries Association, Sue Ryder and the CHC advocacy group Beacon.”

The committee's words, from the inquiry page on parliament.uk ↗.

What it found

In the committee's words, from the summary of 13th Report - NHS continuing healthcare funding ↗

NHS continuing healthcare (CHC) funding is intended to help some of the most vulnerable people in society, who have significant healthcare needs. But too often people’s care is compromised because no one makes them aware of the funding available, or helps them to navigate the hugely complicated process for accessing funding. Those people that are assessed spend too long waiting to find out if they are eligible for funding, and to receive the essential care that they need. About one-third of assessments in 2015−16 took longer than 28 days. In some cases people have died whilst waiting for a decision. There is unacceptable variation between areas in the number of people assessed as eligible to receive CHC funding, ranging from 28 to 356 people per 50,000 population in 2015−16, caused partly by clinical commissioning groups (CCGs)

interpreting the assessment criteria inconsistently. The Department of Health and NHS England recognise that the system is not working as well as it should but are not doing enough to ensure CCGs are meeting their responsibilities, or to address the variation between areas in accessing essential funding. NHS England wants CCGs to make £855 million of efficiency savings in CHC and NHS-funded nursing care spending by 2020−21, but it is not clear how they can do this without either increasing the threshold of those assessed as eligible, or by limiting the care packages available, both of which will ultimately put patient safety at risk.

What the government said

No government response is linked to this report.

Read the report ↗ Report an error

How the inquiry ran

Each dot is a dated item listed on this page, from the inquiry's opening on 19 October 2017 to 24 January 2018.

Oral evidence 1 Nov 2017
Report 17 Jan 2018
Correspondence 24 Jan 2018
Oct 20172018Jan 2018

What it recommended

The committee's recommendations are not listed here yet. Read them in 13th Report - NHS continuing healthcare funding ↗ on parliament.uk.