Nursing homes may refuse continuing care cases due to ‘low’ NHS fees

Provider associations attack NHS London's 'imposition' of £700 a week fee for continuing care.

Providers say the fee is £250 a week short of what they currently receive

Care homes in London could decide not to accommodate people requiring continuing healthcare due to insufficient funding from the NHS, placing extra pressure on hospitals, providers’ associations have warned.

Strategic health authority NHS London has decided to impose a flat weekly fee of £700 for continuing care patients, but this is £250 less on average than is currently paid to providers, according to the English Community Care Association (ECCA), National Care Association, National Care Forum and Registered Nursing Home Association.

They also condemned NHS London’s decision to unilaterally impose this fee, and said it had assured them that the price and a new contract for continuing care would be mutually agreed and reflect the assessed needs of service users.

Martin Green, chief executive of ECCA, said he thought many providers would refuse to take service users on the terms set by NHS London because they “won’t compromise on quality”. Others might reluctantly continue because they were “cash-strapped”, but the overall effect would be that more people would remain in hospital for longer periods, he predicted.

Green said it was important that nursing home providers in London “act in unison in order to force NHS London to respect the actual cost of care of an acceptable quality”. He said equivalent care in hospital would cost £400 per night, or £2,800 per week, and it was “unacceptable to ask nursing homes to provide quality care at one quarter of this cost”.

Des Kelly, executive director of the National Care Forum, said the imposition of the £700 flat fee “takes no account of the complexity of care and whether nursing staff might be required to meet individual needs”.

He said London was the first region in which a strategic health authority had taken the lead in setting continuing care fees on such a large scale.

A spokesperson for NHS London said: “It is wrong to say this decision was made by NHS London. This decision was made by local clinicians and commissioners from across the capital.

“A fair price has been set for all providers so that families can choose their care homes based on the quality of care and not how much it costs. This pricing has been agreed locally by clinical commissioning groups and is in line with the Department of Health’s guidance.

The setting of a single London wide price will inevitably result in some providers receiving higher prices whilst others will receive reduced rates compared with what they are currently charging. However setting a fair price is the only way to ensure providers can compete on quality alone.”

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