Government needs to provide answers on continuing healthcare

Further clarity is needed in terms of changes to the National Framework for continuing healthcare (CHC), and if it is not provided soon, we could see the social care system finally reach breaking point, says Chris Evans MP.



For the majority of us, continuing healthcare (CHC) is something that we will never have to consider, let alone even hear of. Yet it is something that, as of last month, over 54,000 people in England are reliant upon.

CHC is a care package funded and provided by the NHS for adults with long-term, complex health needs. Eligibility for CHC is assessed on need, rather than condition. However, CHC eligibility is common amongst those with degenerative illnesses such as Motor Neurone Disease or Parkinson’s Disease.



In November 2017, the Public Accounts Committee led an inquiry into a National Audit Office report on the funding of CHC. The Committee set out a list of recommendations for the Government based on the findings of the report, which the Government responded to earlier this year. Unfortunately, most of the recommendations have barely been taken on board, leaving patient groups reliant on CHC unsure if they will continue to be considered eligible.



The issues with CHC were already extensive. While an eligibility decision is supposed to be made within 28 days of the assessment date, during the last quarter of 2017-18 a total of 5,449 patients were left waiting past this limit. Shockingly, almost 30% of these patients were left waiting 26 weeks or more to hear the outcome of their assessment. For many people reliant on CHC, time is precious. For those with degenerative diseases which progress quickly, they simply do not have six months to waste waiting for the healthcare that they clearly need.



Clinical Commissioning Groups (CCGs) are responsible for administering and approving eligibility for CHC, yet the way they interpret the National Framework for eligibility varies widely from group to group. This difference of interpretation indicates that the Framework is in urgent need of clarifying. There are too many patients at risk of being denied the care that they desperately need, which can cause unnecessary stress and financial pressures for themselves and their families.



Furthermore, the Government’s breakdown of the proposed costing of efficiency savings concerning CHC is vague. Greater assurance is needed that financial savings are not achieved by restricting access to care for vulnerable patients. The Government estimate that they can reduce spending by around £855 million on CHC delivery, and there are concerns that these savings will come at the great cost of the patient. It is vital that the Government do not make cuts to care packages or the level of support made available to patients. CHC funding is already strained, and it is not fair on patients who already have to endure long waits to hear confirmation of eligibility to then receive a lesser quality care package than the one that they require.



As Secretary for the APPG for Motor Neurone Disease I have met with a number of people who are reliant upon CHC, and the concerns expressed in the NAO report and PAC inquiry are shared by the CHC Alliance, a charitable organisation comprised of groups such as Parkinson’s UK and the MND Association.

The consensus of these organisations and patient groups is that the Government’s response is not good enough, and once again they are ignoring the recommendations of Select Committees.



Further clarity is needed in terms of changes to the National Framework for CHC, and if it is not provided soon, we could see the social care system finally reach breaking point.



Chris Evans is Labour MP for Islwyn