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NHS Continuing Care Funding - What's Wrong?

Before October 2007 each health authority had it's own set of guidelines governing who would and who would not be eligible for continuing care funding.

In October 2007 the government sought to standardise these by issuing a framework document that applies nationally, purportedly in an effort to eradicate the post code lottery that existed before. This met with some success.

In 2009 the framework was revised.

The guidelines contain a Decision Support Tool ("DST") which health authorities have to complete as part of their decision making process. This contains 11 "assessment domains" ranging from behaviour to mobility and scores from "no needs" to "priority".

We have dealt with scores of these DSTs whilst acting for families seeking CHC funding.

The Problem

Where there are differences between the family and NHS nurse assessors as to the score to be given in a "domain" (i.e. an area of need) we sometimes obtain an independent expert assessment.

The assessors we instruct are highly qualified and experienced in dealing with these matters and very often arrive at different assessment scores to those of the NHS.

This is because these assessments are inherently subjective. What may score "severe" to some assessors may present as merely "high" to others.

The solution

The system requires a clearer scoring mechanism with specific benchmarks in order to promote consistency within the assessment process.

Robert T. Campbell
Robert Campbell and Company

 March 2011

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