How the system of ‘continuous healthcare’ is failing sick and elderly people | Letters
I sympathize with Dr. Michael Duxbury (Letters, December 29), but no amount of empathy will increase the likelihood that his mother, or anyone else’s loved ones, will qualify for Continuing Health Care (CHC). Pardon the lighthearted tone, but having worked in the health and social care sector for over a decade I had always hoped that proper integration of health (NHS responsibility) and social care (local authority responsibility) would ridiculous framework would eradicate.
CHC is a funding stream managed by local integrated care systems (ICS), where people with a primary need for healthcare (not social care) have their entire care package paid for by the NHS. Unlike social care, the person is not charged for this care. Eligibility for CHC is assessed and decision makers consider four key components of the person’s needs: nature, intensity, complexity and unpredictability. In practice, I have found that decision-making is undoubtedly influenced by an overarching need to contain expenditure.
According to NHS Digital StatisticsThe number of people eligible for CHC has declined by population size between 2017-18 and 2023-24, despite evidence that a greater number of people are living with complex needs. I do not believe the decline is due to lower awareness of this funding stream, but a drive by the ICS and NHS England to protect their pockets.
The biggest farce is the amount of public money spent by local authorities and ICSs arguing over who should pay for someone’s care if its eligibility is disputed. These are complicated systems for families to navigate, leading many to seek legal advice at a time when their loved ones’ conditions could deteriorate further.
I hope that one day we will have the well-funded and integrated health and social care system that so many of us have been calling for for so long.
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I wish Dr. Michael Duxbury the best of luck in securing continued health care for his mother. I share his suspicion that the system is designed to fail. A close relative is in a care home paying almost £200 a day because he was assessed as ineligible for CHC, even though hospital staff deemed it unsafe to make care visits to his home as he requires 24 hour care has.
When a care home became the only option, the first request for information was not about his health, but about his financial position. So they immediately found out that he had savings and owned his apartment. From then on, at every meeting about CHC funding, where I spoke on his behalf because he is unable to do so, it was clear that money was the most important thing about him. In the end, I was defeated by people determined to minimize whatever medical problem he has.
Funding for people needing healthcare outside a hospital setting has become opaque, with council and NHS staff supporting each other in getting money out of vulnerable people. A bright light must be shined on the entire system.
Janet Maitland
East Finchley, London
My husband is 91 and, I think, in the same situation as Dr. Michael Duxbury’s mother. I have tried to get CHC three times without success. I receive funded nursing care of just over £1,000 per month, but I still need to find over £7,800 each month for his care. I understand that his care home was recently posthumously awarded CHC for two residents, which shows what a cruel system this is.
Angela Huxter
Wantage, Oxfordshire
I discovered CHC when I was researching my then 96-year-old mother’s right to financing. Her nursing home manager said, “You can try, but hardly anyone gets it.” I tried, the first time without success, the second time with success. I paid more attention to her tissue-thin skin that was in danger of breaking off. That was the deciding factor.
Sue Leyland
Hunmanby, North Yorkshire