NHS Continuing Healthcare assessments
The Local Government & Social Care Ombudsman has recently found an ICB at fault over its policy on Continuing Healthcare (CHC) referrals. It is a good (bad) example of organisations creating their own local policies that do not follow statutory guidance.
The case concerned a complaint made by the son of the man who was in hospital. The ICB refused to assess his father’s eligibility for NHS Continuing Healthcare in hospital or provide him with interim NHS funding for the nursing home placement he was discharged to. The Ombudsman stated:
‘Despite not providing interim ‘discharge to assess’ funding for this cohort of service users, the ICB also has a blanket policy of refusing to accept CHC referrals for them until other organisations have arranged onward care and support for them. The ICB’s justification for this policy is that, without it, its resources would be under undue pressure to complete full CHC assessments in the community within 28 days of receipt of the referral. I.e. that if it took, for example, a further seven days to arrange and start a community placement, the ICB would be left with only 21 days to complete its assessment.’
‘This puts the ICB’s resources and targets ahead of the needs of its service users. This policy approach is fault and not in line with the National Framework or the Discharge Guidance.’
The Ombudsman was critical of the ICBs approach to ‘cherry picking’ parts of national guidance whilst ignoring other parts: ‘Overall, the ICB appears to have implemented policies which place service users with chronic, unimprovable conditions in a financially worse position than those with potential for recovery or change in their needs once outside the acute hospital environment. On the one hand the ICB is relying on, and adhering unwaveringly to, guidance about not assessing a person’s needs too soon, and avoiding assessments in the inpatient environment. In short, the ICB is saying it will not assess people in the inpatient environment because this is too soon and needs may change. It is failing to properly consider the individual circumstances of each individual when making its decision about whether to carry out an early assessment.’
‘But, on the other hand, the ICB appears to be ignoring guidance about the need to facilitate interim care and support to allow time for peoples’ needs to settle.’
Download the report: https://www.lgo.org.uk/decisions/adult-care-services/assessment-and-care-plan/25-010-609
Edge Training deliver training on the Care Act & CHC interface. If you would like to enquire about commissioning us please email admin@edgetraining.org.uk or call 07825 731139.
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