However, Mr Burnham’s announcement came as the charity Age Concern and Help the Aged released new figures which indicate that providing more NHS services at home may not be enough to help older people stay independent.  Their survey results reveal that 60% of older people do not think councils give them enough support to help them stay in their own homes.  80% of respondents rely on friends, neighbours and paid carers to help them manage basic tasks such as shopping and cleaning.  Charity director Andrew Harrop comments: ‘Our research clearly shows older people are struggling to live independently in their own homes because the system is failing to provide them with an adequate level of care.  Older people and their families deserve a care system which enshrines dignity and fairness – it’s time for our politicians to deliver this for them.’

• Make sure you claim all the welfare benefits to which you are entitled.  Disability Living Allowance and Attendance Allowance are not currently means-tested.
• If your condition changes, ask for your care needs to be reassessed as you may qualify for more support.
• Sign over property and assets or place them in trust so that your estate is worth less than the threshold (currently £23,000) over which you have to fund your own care.
• Consider taking out long-term care insurance.
• Buy an immediate-care annuity, which provides you with a tax-free income to help meet some or all of your care costs – although this must be paid directly to the care provider.
• Always consult an independent financial adviser specializing in long-term care funding (ask if they have taken the CF8 exam) before you take any action on care fees planning.

The Telegraph’s advice is relevant to people whose primary need is for social and personal care.  Anyone with an overriding health need should be assessed for continuing care, which is funded by the NHS.  If you or a relative is paying for care which you feel should be funded by the NHS due to a serious health condition, please contact Cheselden so we can review your case.

The proposed frailty programme seems to us the ideal way to look after patients who do not need to be treated urgently in hospital. ‘

Anyone who feels that they or a relative should receive NHS continuing care funding – now or in the past – due to an overriding health need should contact Cheselden immediately so that we can review your case.

The public services ombudsman has ruled that the Welsh NHS ‘failed in its duty’ to fund and provide care for a patient, known only as ‘Mr B’, who sustained serious head injuries after being attacked. Mr B’s parents had to pay a substantial amount of money from their retirement savings for private treatments after he was discharged from hospital in May 2007. The ombudsman’s report criticises the NHS for not providing a ‘large part’ of the care package that Mr B needed. As well as paying for health care, the NHS should have funded other treatments such as speech and occupational therapy, but Mr B’s family ended up having to pay for these privately. The ombudsman has recommended that all these costs should be refunded by Carmarthenshire Local Health Board (LHB) along with ‘other financial redress’, and has ordered Mr B’s needs to be re-assessed so that a new care package can be drawn up. The LHB has accepted the ombudsman’s report and has apologized for the distress and inconvenience caused to Mr B and his family. It has promised to accept and implement the ombudsman’s recommendations for Mr B’s ongoing care as well as for financial restitution.

posted by Cheselden Continuing Care at
23:19

The Daily Mail reports that a Wiltshire woman suffering from severe dementia has been denied continuing care funding as her PCT does not consider she has an overriding health need. The decision is being challenged by Phyllis Knight’s daughter, Angela Howard. Mrs Knight has been living in a care home since her husband, who cared for her, died three years ago. Even then, her dementia was so advanced that she remained in her home with her husband’s body for four days, unaware of the situation, until he was discovered. Mrs Knight now receives 24 hour care, at a cost of £825 per week, as she is unable to dress or feed herself. Her daughter comments on her attempts to overturn the PCT’s funding decision: ‘There are so many people having to fight these paper battles with bureaucracy at a time when they have got all these stresses going on in their lives. The authorities hope that people like me will give up, but I will not give up this fight for my mother.’ She has already lost an appeal hearing which took place in September 2009, and Mrs Knight’s case will now be heard by an independent review panel. Wiltshire PCT maintains that it followed national guidance when assessing Mrs Knight’s case, but a spokesperson for the Alzheimer’s Society commented that: ‘We are aware of thousands of families struggling to obtain free continuing care. The eligibility criteria need to be clearer.’

posted by Cheselden Continuing Care at
23:13

After an 11 month campaign, NHS Devon has finally told Harold Cunningham that continuing care funding will be reinstated for his severely disabled wife. Funding was withdrawn from Mrs Cunningham – who needs 24 hour care after being badly hurt in a car crash in 2001 – and many others by Devon PCT in an attempt to correct a large overspend in its 2008-9 continuing care budget. However, the Strategic Health Authority investigated the PCT’s treatment of continuing care cases and ruled that this was not of ‘acceptable quality.’ The SHA then ordered that all cases where funding had been withdrawn should be re-assessed. Mrs Cunningham was assessed in October and continuing care restored in December. Her husband comments: ‘It is a very stressful time just wondering what…you would do if Maureen didn’t get nursing care – it was unthinkable. I just felt relief and am so happy now.’ Mr Cunningham urges anyone in his situation to persevere with their claim for funding and ‘…not to be put off by the first hurdle.’

Anyone who feels that they or a relative has been wrongly assessed as ineligible for continuing care, or who has had their funding withdrawn, can contact Cheselden for a free, no-obligation assessment of their care.

posted by Cheselden Continuing Care at
08:40

The Department of Health has published a report outlining its 5 year plan for reshaping the NHS. Entitled ‘NHS 2010-2015: from good to great. Preventative, people-centred, productive’, the report tells how the NHS plans to meet the country’s increasing care needs whilst dealing with the financial constraints of the recession. Its publication comes in the wake of a recent report from the charity Age Concern, ‘Waiting for Care’, which describes how current NHS targets and initiatives are not meeting the most pressing needs of the UK’s elderly population.

Chapter 2 of the NHS report describes how it will deal with the health and social care issues posed by the UK’s ageing population, in particular long-term health needs, by focusing on preventative medicine, more personalised care with greater patient choice and wider access to community care. Specific measures that will be implemented include:

• Individual strategies to tackle the five most common long-term illnesses: respiratory disease, diabetes, heart disease, asthma and dementia. Notably, the report proposes reducing the use of anti-psychotic drugs to treat dementia by a third over the next 3 years.
• Support for patients to ‘self-care’ at home, reducing traumatic hospital admissions and allowing better management of their condition.
• Joint working with social services and wider access to services such as GPs, to provide better community support.
• Tackling all forms of discrimination, including ageism, and promoting patients’ rights to safe, effective treatment.
• Introducing the National Care Service from October 2010, which will include free personal care at home to all elderly people that require it, helping them to stay independent for as long as possible.

The report can be read in full or downloaded from the Department of Health’s website.

posted by Cheselden Continuing Care at
08:16

Businessman and former chief executive of Granada TV Gerry Robinson has made a two-part BBC documentary entitled ‘Can Gerry Robinson fix dementia care homes?’ Further to his own experiences with his father, who died of dementia, Mr Robinson decided to investigate the standards of dementia care that are available in England’s care homes and expose the problems that the care industry is facing. These quickly became apparent in part 1, aired on 8 December. During a visit to Woodland House in Torquay, staff explained how they receive little or no training in dealing with dementia patients and felt undervalued by their employers. Other problems are caused by the lack of activities for residents and staff being too busy to attend to their needs promptly. Mr Robinson then visited another home, Merevale, where high staff to patient ratios and a broad programme of activities for residents result in a completely different atmosphere, where residents get involved and help to run the home. As well as keeping the residents happy, providing this kind of care also makes good business sense as Merevale is rated ‘Excellent’ and is always full. In Part 2, Mr Robinson will implement the Merevale approach at another care home, Summervale, in a bid to both improve the quality of life for residents and to turn the home into a viable business.

You can watch part 1 of ‘Can Gerry Robinson fix dementia care homes?’ on BBC iPlayer. Part 2 will be broadcast on Tuesday 15 December on BBC2 at 9pm and will be available on iPlayer after that date. More information on the programme is available at the BBC’s Headroom website, where you can also download a free factsheet about dementia care.

posted by Cheselden Continuing Care at
01:15

Assembly Member for Wrexham Lesley Griffiths has urged Wales’ army of unpaid carers to make the most of the benefits and support that are available to supplement their income and protect their pensions. Over 375,000 unpaid carers provide around £4.7 billion of free care every year in Wales, yet many of them do not realise that they are entitled to benefits such as Carer’s Allowance, council tax discount, pension credit and housing benefit. Speaking in support of Carers UK’s national carers’ rights campaign, Ms Griffiths commented: ‘It’s a real concern that carers may not be getting all the help they are entitled to. Carers are fulfilling a vital role in society and without them the NHS and social care system would not be able to cope. It is essential that they are given information about their rights so that they get the support they need in order to plan for their futures.’ Roz Williamson of Carers Wales added that in particular, carers should seek advice to protect their pensions if they have been unable to make regular National Insurance contributions through paid work. Information and a free booklet are available from Carers UK’s free telephone line 0808 808 7777.

posted by Cheselden Continuing Care at
01:06

The Times has revealed that Gordon Brown’s recent pledge to provide free social care to England’s 400,000 neediest people will come at the expense of vital funding into diseases such as dementia. Questions were raised over how the Government will pay the £670 million bill for providing the free care as soon as the Prime Minister made his announcement. And now the Times has discovered that £60 million of NHS money, earmarked for research and development, will now be diverted into the social care funding pot. The former health minister Lord Warner has called for more information to be made available on exactly which research budgets will be diverted from the NHS into social care. However, research funding for conditions such as Alzheimer’s has already fallen by 7% in 2009 – despite repeated appeals from experts and charities that a huge increase in funding is needed if the UK is to cope with the rising number of dementia patients. At present, there are around 700,000 people with dementia in the UK and this figure is expected to double by 2025, with an estimated cost to the NHS of £1.7 billion per year. Current health minister Phil Hope has denied that the reduced investment in dementia funding represents a cut down on dementia research, arguing that many proposals for funding in 2009 have been turned down as they were not up to the required standard. But the Alzheimer’s Research Trust responded angrily to these claims, stating that: ‘The Department of Health claimed it will find £60 million for care from its research budget and in the same week said its dementia research spending has fallen. This smacks of the sort of short-termism that is causing us to sleepwalk into a dementia crisis. The Government needs to significantly increase its funding for research and it must do it now.’

The Government has also been roundly criticised by opposing parties for making false promises about social care and dementia funding in an attempt to win over voters in next year’s general election.

posted by Cheselden Continuing Care at
01:01

The helpline FirstStop Advice has reported a large increase in calls from people enquiring about continuing care funding. Many callers are seeking refunds for care fees that have already been paid or want to find out if they are entitled to continuing care funding. This spate of enquiries is directly linked to the recent payout received from Pauline Hardinges from Cornwall and Isles of Scilly PCT for fees she had wrongly paid for her mother’s care. Despite being asked by the PCT to sign a confidentiality agreement, Mrs Hardinges decided to speak out to make others aware that they may be entitled to free care or to reclaim costs. Cheselden Managing Director, Colin Ball, comments: ‘It’s great that more people are finding out that they may be entitled to continuing care funding and that Mrs Hardinges’ experience is giving them the confidence to question their current or previous care arrangements. We urge anyone who thinks that they or a relative has wrongly paid, or is paying, for care that should be funded by the NHS to contact Cheselden straightaway so that we can review your case.’

To find out if you or a relative should be receiving continuing care funding, or if you are eligible for a refund of fees already paid, please complete Cheselden’s brief questionnaire so that we can assess your case free of charge and with no obligation to proceed. Or call us on 0845 659 1588.

posted by Cheselden Continuing Care at
17:40

The Conservative party has described how it will reshape healthcare funding so that NHS money is given to public health boards that will distribute it across healthcare, housing and local government. Shadow health secretary Andrew Lansley believes that creating the new public health boards and ‘ring fencing’ the funds in question will help to save on future health costs. Preventative care for the elderly, enabling older people to live in their own homes for longer, would be a priority with technology such as telecare monitoring and home adaptations helping to maintain independence and reduce the need for costly interventions such as hospital admissions. Speaking at the national children and adult services conference, Mr Lansley commented that the new system would simplify the current separate, health and social care services which cause ‘…far too many elderly people and their families…to straddle the services for physical ailments, mental illnesses and long-term care in a system beset by red tape and bureaucratic barriers to early intervention.’

posted by Cheselden Continuing Care at
18:06

Speaking at the national children and adult services conference, Andy Burnham has pledged that age discrimination in the NHS and social care services will become illegal by 2012. The health secretary’s announcement was made after research commissioned by the Government revealed that older people are receiving a lower standard of treatment from the NHS and social services than younger people. In particular, the care given to elderly stroke patients and older people suffering from mental health problems was singled out as markedly worse than the care received by younger patients. A survey undertaken as part of the research revealed that 50% of doctors that care for older people consider the NHS to be ‘institutionally ageist.’ Mr Burnham commented on the research and on the 2012 deadline to bring in the new legislation: ‘The age discrimination ban in the Equality Bill should apply for health and social care across England, Wales and Scotland at the same time as other sectors – in 2012. Meeting that deadline is ambitious, but achievable – and it’s vital if a central tenet of the national care service, the pursuit of fairness and equity, is to be upheld.’ A spokesperson for the NHS recognised that attitudes towards older people need to change, but that this change has to be echoed in the wider community as ‘…the NHS does not exist in isolation.’

Mr Burnham also told the conference how the forthcoming National Care Service, that will integrate the funding and running of health and social care services, will eradicate the current problems faced by the elderly where ‘…people play a random game of chance – with their financial wellbeing as the stake.’

posted by Cheselden Continuing Care at
18:02

The NHS has updated its public information booklet on NHS continuing healthcare and NHS-funded nursing care further to the review of the National Framework that took place from October 2008. The new leaflet reflects the changes made to the National Framework in the revised version that was published in July 2009. Although the basis for eligibility decisions and the overall principles of continuing care remain the same, the tools used during the assessment process have changed slightly to give greater clarity about types and levels of patient need. The tools also require more information to be completed; in particular, input from the patient, their relatives or carers, who should be closely involved throughout the assessment process. The main change is to the Fast Track Pathway Tool, which is completed by an appropriate clinician who considers that a patient’s condition is rapidly deteriorating and may be terminal. The PCT is now obliged to fund continuing care for the patient upon receipt of the completed Pathway Tool – it could previously use its discretion – until such time as a full assessment can be carried out. As well as changes to the decision-making tools, the review process has also been clarified. You can download the new NHS leaflet in PDF format by clicking here.

From 1 October 2009, the changes made in the revised National Framework became mandatory for all PCTs and NHS Trusts in England. Under the National Health Service Act 2006, the NHS has now issued revised NHS Continuing Healthcare (Responsibilities) Directions and Delayed Discharge (Continuing Care) Directions to all PCTs and NHS Trusts. These documents can also be downloaded from the DoH website.

posted by Cheselden Continuing Care at
14:47

As of 1 October 2009, the organisational structure of NHS Wales has changed. The previous system of eight NHS trusts and 22 local health boards (LHBs) has been replaced by three new LHBs. The new LHBs will be responsible for secondary care services including hospitals and community services as well as primary care services such as GPs, pharmacies and dental surgeries. A key aim for the new boards will be to reduce unnecessary hospital admissions, by providing as many services as possible within the community or at the patient’s home, and to reduce waiting times for operations. In an article on the Wales Online website, Welsh NHS Confederation policy and communications manager Jonathan Davies expresses the organisation’s commitment to balancing the growing need for continuing care funding against budgetary pressures. He comments: ‘Increased pressure and demand on NHS services from an ageing population whose needs are often complex will mean that the new NHS faces a steady growth of demand for its services. The impact of the growing number of elderly patients will also lead to increased numbers of people being eligible for continuing healthcare. It is important that these patients receive the appropriate care in the right clinical setting. But, as a result of the Grogan legal judgement, the cost impact on the health budget will be substantial.’ For more information on the new LHBs and the areas of Wales they will cover, please visit the NHS Direct Wales website.

posted by Cheselden Continuing Care at
12:37

NHS Devon, formerly Devon PCT, has published the long-awaited report of its joint investigation with the South West SHA into the county’s continuing care eligibility assessment practices. As previously reported, more than 70 families in Devon had their funding suddenly withdrawn earlier this year after NHS Devon reviewed the eligibility of 300 patients for continuing care funding. At the time, the families alleged that the decisions to remove funding were taken for purely financial reasons as the then-called Devon PCT had identified a £13.9 million overspend in its continuing care budget. Although the report acknowledges that financial concerns in part prompted the review of the 300 cases, it also explains that NHS Devon was experiencing an unusual rise in the number of cases that were found to be eligible for continuing care funding and undertook the review in order to check whether the patients in question were, in fact, eligible. The report describes how problems arose because the reviews were not of ‘acceptable quality’, were undertaken too quickly and often failed to adequately involve the patient or their carer. It also criticises NHS Devon for not halting and revisiting the review process when it started to become apparent that large numbers of people were having their funding withdrawn. As well as ordering NHS Devon to re-review the 300 cases for eligibility, the report sets out a number of recommendations that the Trust should follow, both now and in the future, to ensure continuing care ‘best practice’. These include:

• Appointing a continuing care ‘Patient Champion’ who will work to ensure that the patient’s interests are kept central to the assessment process
• Involving the patient and their relatives or carers in the assessment process and keeping them informed about decisions and how these were made
• Clarifying the decision-making process and the roles of Area and County Panels for those cases that require review
• Ensuring that paperwork is properly and consistently completed, in particular that the reasoning behind an eligibility decision is always recorded
• Personalising letters about decisions so that individuals are given a specific reason if they have been turned down for funding, rather than just being sent a standard letter
• Benchmarking standards and ways of working with those of other NHS Trusts to ensure that NHS Devon offers a comparable service to other Trusts in England.

The report can be read in full at NHS Devon’s website.

The Exeter Express and Echo, which has supported the families’ appeal, reports that NHS Devon’s report and its findings have been largely welcomed by the affected families. However, there are still concerns that the re-review ordered in the report will result in some patients once again having their funding withdrawn, in which case the families have stated that they will ‘continue their fight.’

You can read Cheselden’s official comment on the NHS Devon report in the Media section of the website.

posted by Cheselden Continuing Care at
16:38

The Department of Health has reported that 32 NHS Trusts, as well as four ambulance trusts, are failing to meet the minimum standards required. On top of these, 28 Trusts are having their performance reviewed and a further eight are ‘Underperforming’. The performance results have been announced by the Department for the first time in its quarterly publication for 2009-2010. Trusts have been assessed under a points-based system which includes aspects such as financial management as well as the quality and safety of patient care. Those that are underperforming will be given the opportunity to improve before being categorised as ‘Challenged’, which triggers an external review of the Trust’s operations. If the situation still does not improve, a ‘Failure regime’ will then be imposed on the Trust, which could involve a compulsory removal of the board or an enforced merger with another Trust. More information can be found at the Department of Health’s website.

posted by Cheselden Continuing Care at
16:31

It has been revealed that healthcare assistants and auxiliaries are carrying out a host of nursing tasks in English hospitals despite receiving little training and not being required to register with a professional body. As well as basic tasks such as washing patients, assistants are being asked to perform technical duties such as heart tests, blood checks and even working in high-dependency wards. In its report on the issue, the Sunday Times describes how nurses are ‘delegating’ these tasks to unqualified assistants as they consider them to be menial. The newspaper spoke to a healthcare assistant who told how qualified nurses on her ward concentrate on paperwork whilst healthcare assistants wash and feed the patients. She also described her concerns at being asked to perform duties such as ECGs that she did not feel comfortable with.

There are 150,000 unqualified healthcare assistants and auxiliaries working in the NHS and the Royal College of Nursing is now demanding that, instead of just being used to cut costs in hospitals, these staff receive proper training. At present, they can choose to study for NVQs but these are not compulsory. A Department of Health spokesperson commented: ‘Local NHS organisations need to plan and develop their workforce to deliver the right staff with the right skills to meet the needs of their local populations and ensure high quality care for patients.’

posted by Cheselden Continuing Care at
16:25

Wales Online reports that the Welsh NHS is to be overhauled with the core aim of treating more patients in the community and keeping them out of hospital wherever possible. The current system of running primary and secondary healthcare services separately is to be abolished from October 2009. The existing NHS trusts and local health boards will be replaced by new, integrated local health boards (LHBs) which will provide all healthcare services under a single umbrella. In making this move, Wales is following the example of Scotland and Northern Ireland who have already implemented single organisations to run all their healthcare services. The main aim of the LHBs to provide community health services so that people can be treated outside hospitals was a major recommendation in Derek Wanless’ 2003 review of the Welsh health service. Dr Richard Lewis, Welsh secretary of the British Medical Association comments: ‘This is an opportunity to deliver some of the recommendations that Wanless made – that the NHS needs to focus on high standards of primary and community care services to give patients better healthcare in the right place and not necessarily in expensive secondary care facilities.’ As well as improving standards of care and cutting costs where possible, the new system aims to be more responsive to patients’ needs, to enable earlier intervention and treatment and to provide faster access to better co-ordinated health services.

posted by Cheselden Continuing Care at
16:21

A new scheme has been introduced in North East Wales that aims to improve the diets of elderly people in the area and help to stamp out malnutrition. The project is being jointly funded by the Welsh Assembly, Flintshire Local Health Board and the Wrexham Health, Social Care and Wellbeing Partnership. The Prevention of Malnutrition Project will be led by Tony Burgos, a specialist dietician based at Wrexham Maelor Hospital. In Wales, more than 1 in 10 people over the age of 65 is malnourished, amounting to around 5,800 people in the North East region. There are serious health implications for sufferers, as Tony Burgos explains: ‘If it’s not spotted early on it can lead to debilitating problems such as muscle wasting, increased risk of falling, more infections, longer healing and recovery from illness, and longer stays in hospital.’ The cost of treating people that are suffering from malnutrition across the UK is around £13 billion and with the elderly population steadily increasing, this cost is set to rise unless the diets of elderly people can be significantly improved. The Prevention of Malnutrition Project aims to achieve this by working with elderly people and their carers in hospitals, care home and in the community to establish best practice in North East Wales which can then be rolled out across the country and beyond.

posted by Cheselden Continuing Care at
09:33

Hospitals in Wales are trialling a new communication system which will help reduce the risk of gaps in a patient’s care and allow staff to respond more quickly to changes in their condition. The ‘1,000 lives’ campaign aims to improve the way that patient care is handed over from one member of staff to another by encouraging staff to use the SBAR system. Originally used by the armed forces, SBAR involves staff members completing a form to provide essential information about a patient’s condition that is then shared with other healthcare professionals that are involved in the patient’s care. For example, a nurse might complete the form at the end of a shift and pass it on to the nurse working the next shift. The form will prevent the patient having to be repeatedly reassessed or asked the same questions by different people. The information it provides will also enable a patient that urgently needs help to be treated more quickly as staff will immediately be made aware of their condition and situation. It is hoped that the implementation of SBAR will result in increased speed and efficiency of patient care as well as reducing the likelihood of harm caused by delayed treated or poor communication. For more information on the ‘1,000 lives’ campaign, please visit the NHS Wales website.

posted by Cheselden Continuing Care at
13:20

Cheselden’s Managing Director Colin Ball has spoken out against the huge legal costs faced by families who employ law firms to help them reclaim care costs that have been wrongly paid. Colin made his comments in an official Cheselden press release that responds to the recent publicity in the Daily Mail and elsewhere around three cases where families have been repaid over £350,000 in total by the NHS which they were wrongly charged for their relatives’ care. Says Colin: ‘Whilst it is good news that these families have finally obtained restitution, it is wrong that they are paying massive legal costs to reclaim money.’ Most of the publicity around the three cases focuses on the fact that the families have at last got their money back, but Colin points out that families should not have to face the added burden of massive legal fees on top of the stress and frustration of the restitution process. He explains how Cheselden’s approach is different from that taken by law firms: ‘To avoid putting further stress on these families, Cheselden will fund cases that we consider have a fair claim against the NHS for wrongly paid fees. We only charge a set fee if the case is successful – there are no upfront fees and no nasty surprises. We believe that families should never have to pay lawyers huge amounts of money to fight for money that is theirs by right.’

In the press release, Colin also calls on the Government to bring about long-awaited reform of the continuing care assessment process, in particular to clarify the difference between personal and nursing care and to establish exactly what types of care will and will not be funded. The confusion and inconsistency of the current system has led to Cheselden’s experts being inundated with hundreds of queries – from lawyers as well as affected families – about continuing care and how to tell if someone is eligible for funding. To read the press release in full, please visit our Media section. Or to find out if you may have a case for reclaiming care costs, please complete our simple enquiry form and we will respond to you as soon as possible.

posted by Cheselden Continuing Care at
13:12

The Yorkshire Post reports on a dispute that has broken out between Leeds PCT and the family of a woman suffering from advanced dementia. 83 year old Sheila Fox cannot communicate, move or eat without assistance and is doubly incontinent. Despite the severity of her condition, Mrs Fox has been denied NHS-funded continuing care because she shows no signs of distress. However, her assessors have admitted that they are unable to evaluate her mental condition and therefore have no way of knowing whether or not she is distressed. Her son Adrian has pointed out that patients with similar health needs are receiving funding in other areas of the country and accuses Leeds NHS of withholding funding because they know his mother can afford to pay for her care by selling her property. Mrs Fox’s MP Fabian Hamilton is backing her son’s campaign to obtain full NHS funding and has asked Leeds PCT to review her case. In a letter to the PCT, he describes the denial of funding as a ‘…cynical betrayal of due concern for Mrs Fox who could well still have some comprehension but is now trapped by the failure of her mental capacity and cannot communicate in any way.’ NHS Leeds responded by saying that her case has now been reviewed four times and that Mrs Fox does not qualify for continuing care funding because her health needs do not meet the criteria set out in the National Framework of being ‘unpredictable, intense or very complex’. To read the article in full, visit the Yorkshire Post’s website.

posted by Cheselden Continuing Care at
14:00

A Somerset law firm has raised concerns over the low percentage of people receiving NHS-funded continuing care compared to the national average. Despite having a high proportion of elderly people, NHS Somerset funds continuing care for just 31 people in every 50,000 – a total of 320 individuals. Commenting on the new statistics, recently revealed in the House of Commons, a spokesman for the law firm stated that they are dealing with many cases where patients that should be receiving care funding have been deemed ineligible and, as a result, are being forced to sell their homes to pay for care. However, NHS Somerset rejects the idea that they are not providing enough continuing care funding and a spokesman for the PCT stated that the number of people receiving funding is actually increasing. The PCT also claims that the Government figures are misleading as they do not take into account care that it provides for some people with disabilities or long-term mental health problems.

If you feel that NHS Somerset, or any Primary Care Trust in England and Wales, has wrongly denied continuing care funding to you or a relative – either now or in the past – please contact Cheselden. We will provide a free, no obligation assessment of your case for funding.

posted by Cheselden Continuing Care at
13:58

The Royal Pharmaceutical Society (RPSGB) has revealed that over 50% of people aged 65+ are taking five or more different types of medication – and are not always taking the prescribed dose. As well as the potent danger posed to the individual’s health by mixing medication, drugs that may no longer be required are being given on repeat prescription instead of being reviewed by GPs, wasting NHS money. Over £2 billion – half of the NHS’s total drugs spend – is spent on medication for older people every year. And worryingly, 60% of 500 older people interviewed in a RPSGB survey admitted suffering from side effects caused by their medication which they have not reported to their doctor. 20% said that they are not taking drugs as prescribed and one in seven take them at the wrong time of day. Taking drugs incorrectly or mixing medication can have grave consequences with 17% of hospital admissions resulting from adverse reactions to medication. And over 65s are three times more likely to suffer side effects such as falls, confusion and internal bleeding. The RPSGB is urging older people who take multiple medicines and have not had these reviewed recently to contact their GP or pharmacist as soon as possible to check whether their medication types and dosage are still appropriate for their needs.

posted by Cheselden Continuing Care at
13:16

The Health Service Journal has raised concerns that the new national care service put forward in the recent social care Green Paper will pit the interests of the NHS against those of local authorities. The Paper aims to achieve better co-ordination and working between health and social care services in England. However, a conflict could arise around how funding levels are set. The King’s Fund supports the idea of the Government determining funding levels for each region as this would help to eradicate the current ‘postcode lottery’ and ‘…might also be better for the NHS because there would be less unmet need.’ But Liberal Democrat MP David Rogers, chair of the Local Government Association, considers that a national system would ‘destabilise the whole of local government funding and won’t take into account factors that lead to huge variations in the cost of care’. This could lead to increased strain on the NHS rather than being ‘better’ for it.

Another issue is the proposed abolition of Attendance Allowance, a non means-tested benefit that is worth £3.7 billion to 1.4 million older people. The £3.7 billion saving has been earmarked as a way of partly funding the reforms put forward in the Green Paper. But Stephen Burke of the charity Counsel + Care warns of the implications of abolishing the benefit, commenting: ‘Rather than a discussion on how we pay for care in the longer term, we may see instead a massive rearguard action to defend this benefit, which is very popular.’

posted by Cheselden Continuing Care at
13:05

The NHS and Isle of Wight council have launched a month-long consultation process to gather thoughts and opinions on the IoW’s new end of life care strategy. The strategy aims to support the physical, emotional and spiritual needs of patients and their carers. In particular, it will enable people to die at home if they want to and if their care needs permit. The NHs also hopes that a new approach to end of life care will reduce the number of complaints that it receives from relatives. The three year strategy has received input from a wide range of sources including the IoW’s hospice, GPs, patients’ representatives, care and nursing home staff. Chief Executive of the IoW NHS Keith Flynn comments on the strategy: ‘This draft strategy sets out how we aim to meet the preferences of Islanders so more people can die in a place of their choosing. “It is our understanding many people would prefer to die somewhere other than hospital and the strategy envisages more people being able to choose.’ You can find out more about the consultation process at the Isle of Wight NHS website.

posted by Cheselden Continuing Care at
12:44

The sector skills councils Skills for Health and Skills for Care have unveiled a new set of key skills for all staff that work with terminally-ill people. The move comes in response to the Government’s End of Life Care Strategy, published in July 2008, and is designed to bring about ‘a cultural shift in attitudes and behaviour related to end of life care’ amongst staff working in care homes, hospitals and other settings. Staff will be expected to train in the new competencies and principles in addition to any existing training that they need to undertake for their specific occupation. The core competencies are defined as communication, care assessment, symptom management and advance care planning. These are underpinned by a set of principles which include fully involving the patient in all aspects of their care; keeping families and friends informed about choices and available support; and delivering care in a sensitive, patient-focused manner. You can download the full document outlining the new key skills at the NHS’s end of life care website.

posted by Cheselden Continuing Care at
14:12

The Public Service sector website has published an article describing how using telehealth can save PCTs significant sums of money on the care of older people and those with long-term health conditions, whilst reducing the number of unnecessary and delayed hospital admissions. Telehealth involves the remote monitoring of patients at home by nurses. Information on the patient’s condition is transmitted daily, enabling nurses to pick up on any changes and prioritise the time that they spend on providing treatment. The approach has been shown to reduce acute hospital admissions as well as boosting recovery times for the patient. Telehealth is expected to play a major role in caring for the 17.5 million people in the UK who suffer from a long-term health condition. This group accounts for 80% of GP consultations, 60% of hospital bed use and 69% of the NHS’s primary and acute care budget. Sheffield PCT has recently trialled the use of telehealth for patients with chronic obstructive pulmonary disease. Community nurse visits were reduced by 80% and hospital visits by 50% – saving the PCT up to £40,000 which has been reinvested in more telehealth monitors. It is estimated that the wider use of telehealth could potentially save the PCT £1.2 million per year by dramatically reducing the number of hospital admissions.

posted by Cheselden Continuing Care at
14:08

South West Essex PCT has announced that it will be providing funds to enable better end-of-life care in the county after NHS chiefs admitted that too many patients are dying in hospital simply because there is nowhere else for them to go. The Trust is spending £161,000 on improving services such as palliative care and hospices-at-home as well as providing more places in residential and nursing care homes. Terminally-ill patients who want to die at home will also now have access to drugs that were previously available only to patients in hospital. The PCT aims to reduce the number of people in Essex that die in hospital by 75% over the next five years; Basildon Hospital currently has one of the highest death rates in England. Hospital spokeswoman Luenne Featherstone comments: ‘Sadly, many…patients die while waiting to be transferred to more appropriate care settings…We will continue to work very closely with NHS and community services to ensure sufficient hospice, residential and nursing home provision is available to transfer patients sooner.’

posted by Cheselden Continuing Care at
13:53

The NHS Information Centre has published a report showing that in 2007-2008, the number of people receiving local authority-funded residential care fell, whilst the number receiving community care services – such as domiciliary care – increased. Entitled ‘Community Care Statistics 2007/8: Referrals, Assessments and Packages of Care for Adults, England’, the report is based on information about adult care services provided by local authorities. Key findings include:

• The number of adults receiving care in the 2007-2008 year was around 1.8 million, which was similar to the number in the previous year 2006-2007.
• 10% fewer adults (around 25,000) received care in local authority-run care homes in 2007-2008 than in the previous year.
• 3% fewer adults received nursing care than in the previous year.
• There was a 2% increase (around 11,000) in first assessments of new care clients in 2007-2008.

Robert Lake of the NHS Information Centre explained that the findings were expected and continue recent trends in care provision, commenting: ‘Fewer people are now receiving council-funded care in a residential or nursing home compared to previous years. This is not unexpected, given the government’s aim for more people to receive care in their own homes.’

The report also gives information on related areas such as direct payments, care plans and the assessment of carers’ needs. It can be downloaded from the NHS Information Centre’s website.

posted by Cheselden Continuing Care at
13:46

The Care Quality Commission has published the declarations that NHS Trusts have made on whether they are meeting the 24 ‘Core Standards for Better Health’. The Standards will be used from 2010 to determine whether or not health organisations are fit to be registered with the CQC. The 24 Standards cover all aspects of an NHS Trust’s commitment to its patients and include areas such as infection control, patient safety and a patient’s involvement in their own care. You can read the Standards in full along with the CQC’s report at their website as well as looking up the declarations made by your local Trust. The Patients Association has greeted the CQC’s report with concern, stating that it does not feel that patient safety has been made a big enough priority. Director Katherine Murphy comments: ‘The public mantra of those leading the NHS is still not the reality for patients. Whilst overall there have been improvements, standards have got worse on patient safety when we are being told it is the number one priority of the NHS.’

posted by Cheselden Continuing Care at
13:42

Terminally-ill patients in the Hull area who wish to die at home will soon benefit from the services of a new type of community nurse. The Health and Social Care Assistant (HSCA) role has been created in response to ideas put forward in the Department of Health’s end-of-life care strategy, published in July 2008. The HSCAs will nurse patients in their own homes and provide services in partnership with the existing district nurses. They will also work alongside other partners such as cancer support nurses and hospices in the Hull area. The new service is designed to be highly flexible, with HSCAs spending as much or as little time in the patient’s home as suits the patient – an entire shift can be spent with one person if necessary. As well as offering nursing care, the HSCA will undertake other tasks that will aid the patient’s comfort and wellbeing, such as helping with personal hygiene or preparing basic refreshments. NHS Hull is supporting the initiative with funding of £240,000 per year – enough to pay for 12 full-time HSCAs if the initial trial of nine personnel goes to plan. Stewart Boynton of NHS Hull comments on the new scheme: ‘Our new service offers a fantastic mix of skills and we have chosen an excellent team to go out into the community for the first time. Through a quality driven and patient-led service, we aim to support the provision of round-the-clock care, providing support to those who require vital, end-of-life care.’

posted by Cheselden Continuing Care at
12:37

In a House of Commons debate on 8 June, MPs supported a proposal that direct payments be made available for health services, but requested more details about exactly how the new system would work. If it is passed, the new Health Bill will enable people to receive direct payments from the NHS, giving patients a much wider choice over their care and who provides it. Personal budgets are already available for many social care users in the UK. During the debate, health secretary Andy Burnham stated his intention that health care should ‘proceed in the same direction’ as social care, not just to give patients more control but also for budgetary reasons: ‘…we can bring the two budgets together for people with particularly complex health and social care needs.’ 70 pilots will start from 2010 to test the viability of using direct payments and personal care budgets to fund an individual’s health services. Led by PCTs across England, the pilots will focus on patients with long-term mental and / or physical health needs.

Charities and organisations that campaign for the rights of disabled people hope that if the pilot is successful and new legislation is passed, direct payments will be made available for those people who are assessed as eligible for NHS continuing healthcare. To find out more about the proposed Health Bill, visit the parliamentary website.

posted by Cheselden Continuing Care at
12:33

A new national research centre, the School for Social Care Research, has been launched to investigate how the 1.25 million adults living in social care in Britain can be better cared for. Research will focus on establishing what service users want from social care services and on a detailed analysis of the issues surrounding care provision. The project has been granted £15 million of Government funding and will be undertaken by the universities of Manchester, Kent and York, King’s College London and the London School of Economics. It will start by carrying out a public consultation to identify the key areas of research. Professor David Challis of the University of Manchester comments: ‘It is an important development with the rising numbers of older people in our communities and the need to find effective ways of improving care and support for them, their carers and other groups in need of social care. We will aim to undertake high quality research to address the most important issues and make a positive difference.’ You can find out more about the School at the NHS National Institute for Health Research website.

posted by Cheselden Continuing Care at
12:31

In his Pre-Budget statement, the Chancellor has announced public spending cuts of £5 billion, of which £2.3 billion will come from the NHS. Rather than cutting services, the Department of Health will focus on ‘efficiency savings’. The savings will be implemented from the 2010-2011 financial year. Areas of focus will include:

• £500 million of savings from health authority contracts that are awarded to hospitals and other providers and how much the providers are paid for treatment
• £500 million of reducing the length of hospital stays.

The announcement has raised concerns that patient services will ultimately be affected, with the Patients’ Association commenting that ‘There is no doubt that there are tough times ahead for the NHS when we know through our work [that] services are struggling already.’

posted by Cheselden Continuing Care at
11:50

The British Journal of Healthcare Computing and Information Management (BJHC & IM) reports that the Rotherham Health and Social Economy Partnership is pioneering a new information system that will enable better decision-making about patient care. The Interqual system is designed to help health and social care professionals make decisions about patient admissions, care provision and discharge from hospitals. It is already widely used in the USA. The Rotherham Partnership, which consists of the Rotherham NHS Foundation Trust, Rotherham PCT and Rotherham Social Services, plans to use Interqual across three areas: healthcare for the elderly, orthopaedics and emergency admissions. The Partnership was established to provide Rotherham residents with quick and fair access to local services that cover all their health and social care needs whilst remaining personalised and of high-quality. Brian James, Chief Executive of the NHS Foundation Trust, explains how Interqual will help NHS and Social Services staff make more effective and appropriate decisions about care. ‘Using the same tool to help determine whether an individual patient requires admission or not, whether they are at the right level of care, and when it is appropriate to discharge, creates a win-win situation. The PCT avoids the cost of an “avoidable admission” and the Foundation Trust can reduce the cost of inpatient stays.’ To find out more about Interqual and the Rotherham Partnership, visit the BJHC & IM website.

posted by Cheselden Continuing Care at
16:53

The head of the new Care Quality Commission, Cynthia Bower, has vowed to tackle the existing gap between the nation’s health and social care services. The CQC – the new ‘super regulator’ of England’s care services – aims to improve standards across all areas of care, but is starting with a review into healthcare services that are available to care home residents. Charities and campaigners for the elderly have long been drawing attention to the problems faced by this vulnerable group, including the difficulty of accessing primary health services such as dentists, GPs, nurses and dementia specialists. In an interview with BBC News, reported on their website, Ms Bower admits that these problems and the UK’s ageing population present ‘the biggest challenge facing services in the 21st century…more and more people are going to need access to that care that spans across both social services and the NHS.’ However, she believes that the new single regulator will help in this respect as this will …’focus the minds on the issue…(and) look at how the two are working together.’

The review of standards in care homes, launched on 1 April, will look at both public and private sector homes. It will focus on the quality of primary health care services as well as the level of choice available to residents. Ms Bower has said that the CQC will proactively respond to its findings and will fine homes or close services where necessary. The review has been warmly welcomed by charities such as Age Concern, which comments: ‘Too many older people and their families continue to be horribly let down by health and care services. The quality of care they experience is all too often not up to scratch, so it’s encouraging that this is one of the new commission’s first reviews.’^*

The care homes review is likely to be followed by three other special reviews also focusing on the ‘crossover territory’ between health and social care: care for stroke patients, support for people suffering from mental illness and services for families with disabled children.

The CQC’s work is mirrored by the Government’s launch of 16 pilot projects which also aim to improve the way that health and social care services work together. The £4 million scheme will experiment with different ways of integrating services, rather than retaining the traditional boundary between health and social care, to see how standards for both NHS patients and local authority service users can be improved. Each of the 16 projects will tackle the most pressing health needs in their area including dementia, care for the elderly, substance abuse and end of life care. The pilots were launched on 1 April and will run for two years, after which they will be evaluated and the most successful care models integrated into national best practice. To read more and to find out where the 16 pilot projects are taking place, click here.

^* Age Concern and Help the Aged, now united as one charity, have issued a ‘Seven Point Plan’ for the CQC which can be read on Age Concern’s website.

posted by Cheselden Continuing Care at
16:18

Four National Collaborating Centres (NCCs) that produce clinical guidelines for the NHS have been merged into a single body. The new National Clinical Guideline Centre (NCGC) replaces the former NCCs for Acute Conditions, Chronic Conditions, Nursing & Supportive Care and Primary Care. NCGC will be hosted by the Royal College of Physicians (RCP) and will continue to work closely with the three other Royal Colleges that hosted the previous NCCs. The NCGC will be officially launched on 1 April 2009, when it will become the largest NCC in the UK and one of the biggest in the world. The aim of the new organisation is to produce world-leading, high quality clinical guidance across a wide range of disciplines and it has put in place a number of stringent objectives to help it achieve its goal. NCGC’s new Chief Operating Officer, Dr Ian Bullock, comments: ‘Our primary aim is to work with patients and healthcare professionals in improving the quality and consistency of patient care, and to make a real and lasting difference to patient experience when receiving NHS care.’ Read more at the RCP website.

posted by Cheselden Continuing Care at
11:33

Suffolk PCT has unveiled its plans to develop the county’s community healthcare services by converting the existing Suffolk Community Healthcare (SCH) body into an ‘arms length trading organisation’ by April 2009. Felixstowe TV [link to ] reports that, by April 2010, the organisation will be recognised as an independent legal entity. Along with private providers, SCH will then be invited to submit tenders to supply community health services such as the management of community hospitals, district nursing, health visiting, community dentistry and podiatry. NHS Suffolk has stated that their actions are in line with guidance issued by their Strategic Health Authority and that the creation of competition amongst service providers will lead to a better standard of care for the county’s patients. A spokesperson commented that the Trust has ‘…identified 12 strategic initiatives to deliver progress over the next 5 years on its main 5 goals. Several of these require significant improvements to, and investment in, community health services.’

NHS Suffolk has undertaken extensive research and project work to help staff understand how to commission services that will result in high standards of care, patient experience, integration with other services and value for money. It has announced that it is organising a series of events for patients, GPs and other stakeholders to explain to them the agenda for changing Suffolk’s community health services and the benefits that will result.

posted by Cheselden Continuing Care at
13:56