NHS responsibility for free nursing care delayed 12 months – New version

Full responsibility for funding free nursing care will not
be transferred to the NHS until April 2003, the government has announced after
coming under pressure to defer the changes, writes Lauren Revans.

In
July 2000, the government accepted the Royal Commission on Long Term Care’s
recommendation to remove the anomaly of people paying for nursing care in
nursing homes that is provided free in other settings.

Consultation
guidance on implementing free nursing care published in July 2001 proposed that
the funding of local authority funded residents’ registered nursing care would
be transferred to the NHS from April 2002.

But
concerns raised by the Association of Directors of Social Services, the Local
Government Association, and the NHS Confederation about the proposed timescale
for implementing the changes and assessing all residents have forced the
government to re-consider.

Health
minister Jacqui Smith said: “The deferral in the transferral of funds from
local authorities will allow more time for the NHS and councils to work
together to ensure that the process is carried out efficiently and to the
benefit of older people receiving nursing care.”

Smith
stressed that the change was to enable NHS, social services, and care home
staff to “establish effective working partnerships, and would not effect the
government’s commitment to make nursing care free for all from October 2001.

The deferral means that the seven out of ten
people already receiving care from a registered nurse paid for by local
councils or through preserved rights to higher rates of income support will
receive free nursing between April 2002 and April 2003 funded by local
authorities, not by the NHS.

For the estimated 35,000 people in England
who are funding their nursing home placements themselves, the NHS will become
responsible for funding the registered nursing care they receive from October
2001. All self-funding nursing home residents will be assigned to an
appropriate band of nursing in the first instance, and health authorities will
be allocated money based on the number of self-funders in their area.

People entering the nursing care system after
1 October 2001 will be assessed using the single assessment process, which is
intended to eliminate duplication and lack of compatibility between existing
health and social care assessment procedures. The single assessment process
will then be implemented fully from April 2002 and will be central to the
determination of individuals’ registered nursing needs.

LGA
chairperson Sir Jeremy Beecham welcomed the government’s agreement that “an
additional 12 months until full implementation” would enable the development of
robust arrangements for joint working between councils and the NHS.

Association
of Director of Social Services president Moira Gibb added: “This will allow the
construction of effective financial mechanisms to ensure the smooth transition
which will bring reassurance to the many thousands of elderly people we provide
care for.”

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