Forthcoming report from Ombudsman backs development of national approach to funding continuing care
09 December 2004
Press release 10/04
A key recommendation in the Ombudsman's forthcoming report on funding for long-term care - due for publication before Christmas - was picked up today in the Department of Health's announcement that it will commission 'the development of a national consistent approach to assessment for fully funded NHS continuing care.'
The Ombudsman's report highlights the problems resulting from the lack of a national policy and guidance framework. From the patient's point of view applying for continuing care funding has been a lengthy and sometimes hit and miss process - resulting in real hardship for a number of disabled and elderly people and their carers.
Commenting on the Department's announcement, the Health Service Ombudsman Ann Abraham said: 'I have consistently highlighted the difficulties which result from the lack of a national framework. Following our 2003 report the DoH acted on our call for a review of all those who might have been affected since 1996. However, from the patient's perspective the review process took too long and came up with inconsistent results. Some people who should have received full funding still did not do so, even after the review. For some the result has been the loss of a substantial part of their lifetime savings.'
The Ombudsman's report is based on over 4,000 complaints received about the review process since February 2003. The report suggests that the DoH needs to take a lead, which they have done today by announcing the development of a national framework for continuing care funding.
Evidence set out in the Ombudsman's report recommends that the national framework should include:
- Establishing national minimum eligibility criteria - understandable to health professionals and patients and carers alike.
- Developing accredited assessment tools and good practice guidance to support the criteria.
- Supporting training and development to expand local capacity and ensure that new continuing care cases are assessed and decided properly and promptly.
- Improving record keeping and documentation by those undertaking the assessment process and by those caring for patients.
The report also recommends:
- Seeking assurance that the retrospective reviews have covered all those who might be affected and
- Monitoring the situation in relation to retrospective reviews and using the lessons learned to inform the handling of continuing care assessments in the future.
The Ombudsman adds, 'Our forthcoming report highlights that the only way to make the system transparent and fair, is to have national minimum eligibility criteria, with a national set of assessment tools and guidance on how to conduct and report on the reviews. It is clear from our work that there are examples of good practice and systems in some SHAs which can form the basis for this work. We would be delighted to work with the DoH and the SHAs in helping to develop national guidance.'
For further information contact the PHSO press office, Tel: 0300 061 4996 email: press@ombudsman.org.uk
Notes for editors
- About the Ombudsman - The Health Service Ombudsman looks into complaints made by or on behalf of people who have suffered because of unsatisfactory treatment or service by the National Health Service (NHS). The service is free and the Ombudsman is completely independent of the NHS and the government. The Ombudsman also looks into complaints against private health providers, but only if the treatment was funded by the NHS. The Office can also investigate complaints about other services provided on behalf of the NHS. Not all the special health authorities - for example, NICE and NHS Direct - are in the Ombudsman's remit. For further information see the website
- Where the Ombudsman finds maladministration, the Office usually suggests, or asks the department to suggest, a remedy for the aggrieved person. The Office's aim is to try, if possible, to put that person back in the position he or she would have been in had the maladministration not occurred.
- Continuing care - NHS continuing care is a package of care arranged and funded solely by the NHS for people who need it because of disability, accident or illness. Continuing care can be provided in a range of settings - care homes, patients' homes or hospitals.
- Continuing care complaints - The bulk of continuing care complaints received by the Ombudsman have been requests for the Office to pass on complaints to the appropriate SHA for action. Recently they have included complaints about delays in carrying out reviews and about appeals, once reviews have been carried out. Most complaints are about the decision not to fully fund, the process by which the decision was made and about delays in the payment of restitution.
- The report - The Ombudsman's reports are laid before Parliament and published as House of Commons papers. They are also published on the website
