Council chiefs call for more NHS spending on long-term care

The NHS should spend more money on long-term care packages for people whose needs fall short of the continuing care threshold, local government leaders have said.

In guidance issued to councils, the Association of Directors of Adult Social Services (Adass) and the Local Government Association said more people with significant health needs who are denied fully funded NHS care should receive packages jointly funded by primary care trusts and councils.

Currently, this group is funded by councils or service users themselves in residential care. The exception is the costs of services provided by a registered nurse, which are met by PCTs, and is worth a flat rate of £101 a week.
But the national framework for continuing care, which came into force this month, said that there may be other circumstances where packages should be jointly funded.

The Adass/LGA guidance said this should involve people receiving health or nursing services provided by nurses, auxiliary health workers or care staff that it would not be “reasonable” for councils to fund.

The new framework provides PCTs and councils with a “checklist” designed to provide an initial test of whether people may be eligible for continuing care, given factors including their behaviour, cognitive function and mobility.
The Adass/LGA guidance says anyone not filtered out at this stage, but later denied continuing care after a full assessment, was a likely candidate for joint funding.

The associations also called for councils to set up processes to challenge PCT decisions on eligibility for continuing care, and that trusts and authorities should set up “robust” dispute resolution procedures.

Jo Webber, deputy policy director at the NHS Confederation, welcomed the guidance, but added: “We must ensure that potential funding disputes do not distract our focus from meeting the needs of patients.”

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