New continuing care rules may spark cash row between councils and NHS

Social care chiefs have warned that the government’s forthcoming national continuing care framework may exclude too many people from NHS funding.

The framework was unlikely to comply with case law on continuing care, said Jeff Jerome, co-chair of the Association of Directors of Social Services disabilities committee.

“We are still concerned that it will leave local authorities with a moral obligation to fund people who we are not legally supposed to support,” he said following the publication of an parliamentary ombudsman report into continuing care (see Ombudsman’s report).

The framework is designed to comply with the 1999 Coughlan judgement and the 2006 Grogan judgement. Both said that councils should not fund long-term care for people whose primary need for services was due to a health condition, and that such people should be fully funded by the NHS. This set an upper limit, in terms of need, for councils’ responsibility to provide care.

Jerome said he feared the government’s proposals would leave a gap between the limits of councils’ responsibility and the threshold for NHS funding.

The Department of Health has discussed with the ADSS and others how to develop the framework after the consultation closed in September. Last week, care services minister Ivan Lewis said it would be published in June, although Jerome said he believed this was too soon.

The £110m originally set aside to fund the new framework was “not even remotely adequate”, said Jerome, but he added that he expected some movement on that.

A DH spokesperson said the issue of whether the continuing care threshold would be set too high was being taken into account during the framework’s development, while the final cost was under discussion.

Ombudsman’s report (back)

The Department of Health has published revised guidance for primary care trusts on compensating people wrongly denied continuing care, after criticisms from the parliamentary ombudsman. The new advice says PCTs should aim to restore people to the cash position they would have been in had they been granted continuing care in the first place. The ombudsman said previous guidance demanded PCTs to repay only direct care costs.

Further information

NHS Continuing Healthcare: Continuing Care Redress

 Retrospective Continuing Care Funding and Redress