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Failure to fund continuing care leads to huge surge in complaints

Posted: 03 July 2003 | Subscribe Online


A record number of complaints was made to England's health service ombudsman last year, many of them against health authorities that had refused to fund continuing care in nursing homes.

In her annual report, the health ombudsman Ann Abraham reveals that she received 3,994 complaints in 2002 - a 50 per cent increase on the previous year.

The increase was "almost entirely due" to complaints about the funding of continuing care in the wake of her February report, which criticised four health authorities for wrongly making patients pay for their own care (news, page 10, 27 February).
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"My investigations showed NHS organisations struggling, and sometimes failing, to conform to the law and Department of Health guidance on this issue," Abraham says in the report. "The indications were that the problems might be widespread."

Abraham received 1,300 similar complaints in the six weeks after publication of her report in February. She has since asked NHS chief executive Nigel Crisp to work with health authorities to ensure that local eligibility criteria meet the legal standard set by the 1999 Coughlan judgement.

"In my view it is not for my office to embark on a series of investigations into matters which should fall on the health service to resolve," Abraham writes in the report.

The report has details of three complaints on long-term care, received since February, which Abraham has since upheld.

A complaint by Age Concern against the former Shropshire Health Authority concerned a stroke patient who had no mobility and needed all personal care needs attended to but had been refused NHS-funded care.
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Abraham found that, under the authority's eligibility criteria, no nursing home patient qualified for funding because they had been deemed "fit enough" to be discharged from hospital. Revisions to the criteria made in 2001 were still "overly restrictive" and assessment forms had not been updated, the ombudsman said.

A second complaint against the same health authority concerning a woman with Alzheimer's who was assessed as needing Elderly Mentally Ill care but refused NHS-funded continuing care was also upheld.

The third case concerned another woman with Alzheimer's who was initially assessed by the former Suffolk Health Authority as eligible for funding, but was later ruled ineligible following a second assessment for a placement nearer her husband's home. The ombudsman criticised the authority for having inconsistent procedures (news, page 10, 6 April).

The Health Service Ombudsman for England, Annual Report 2002-3 from www.ombudsman.org.uk


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