Continuing care criteria raise hopes that thousands will receive funding

Thousands of people may have their long-term care needs fully funded by the NHS under a national framework designed to ensure practice complies with legal judgments.

The continuing care framework, published for consultation by the Department of Health this week, would add an estimated 110m to NHS bills annually, by extending continuing care to people who have wrongly been denied it.

This would also cut bills for councils that have had to pick up some of the costs of people refused NHS funding, and faced care fees boycotts from relatives protesting against the denial of continuing care to loved ones (Directors fear spread of campaign as relatives refuse to pay charges, 16 February).

The framework would introduce national criteria, replacing the 28 existing strategic health authority criteria, explicitly based on the landmark 1999 Coughlan judgment. This stated that the NHS should fully fund people whose primary need for long-term care was health based.

While previous government guidance, issued in 2001, referred to Coughlan, a second key ruling earlier this year – the Grogan judgment – dismissed this as unclear (High Court joins chorus of criticism of ‘unclear’ continuing care system, 2 February).

Age Concern care finance policy adviser Pauline Thompson welcomed the eligibility criteria but warned that people could be wrongly excluded by the way it was implemented by primary care trusts.

NHS Confederation deputy policy director Jo Webber also welcomed the framework but added: “There’s no surfeit of funding in the system and what people will be looking for are systems that don’t increase the pressures they have on budgets.”

The proposals would also overhaul the registered nursing care contribution (RNCC) – the system of NHS funding for nursing care for people in residential care. The existing three bands, currently worth 40, 83 and 133 a week, would be replaced by a single band worth 97 a week.

The framework also stresses that the RNCC should only be available to people without a primary health need, who would thereby not receive continuing care.

Critics had claimed that the significant overlap in wording between the 2001 guidance for continuing care and guidelines for the top band of RNCC had resulted in people being wrongly denied full-funding.