Damaging NHS plans halted in Leicestershire
Leicester City and West Leicestershire clinical commissioning groups (CCGs) have confirmed that they will postpone the introduction of a new ‘Settings of Care’ policy for Continuing Healthcare (CHC) services in their area until at least 2018. The decision was confirmed at a governing body meeting held on 11 July 2017. The MND Association was present at the meeting, and a statement has since been issued confirming the move.
This is a very welcome decision for people living with severe disability in the Leicestershire area. The MND Association expressed major concerns about the revised policy, which intended to cap the total funding an individual can receive through CHC at 10% more than the cost of the cheapest available residential care placement. Our key concern is that this arbitrary limit would force people to move into inappropriate care settings for cost reasons alone, regardless of their own preferences or the recommendations of their health and care professionals. People currently receiving care at home or in specialist residential settings would face the extremely worrying prospect of being moved into a lower-cost residential care home that may be entirely inappropriate for them.
Other key concerns included the following:
- The draft policy confirmed that breaking up families does not constitute ‘exceptional circumstances’ for the purposes of the 10% cap. This extremely disappointing, particularly given the impact of family and home life on health and wellbeing.
- The document made reference to CCGs duty to meet the individuals “reasonable need”. The National CHC Framework is clear that the CCG must meet the individuals “assessed need”. The altered language suggested that the CCGs could seek to diverge from this key principle.
- Even where a patient has shown that he or she has exceptional circumstances, the CCGs would retain discretion to decide whether to fund a care package over the 10% cap. This effectively gives discretion for the CCGs to ignore all exceptional circumstances for financial reasons.
- 4% of people who responded to the consultation exercise were not satisfied with the process, reflecting the lack of focus on effective engagement with those most affected by the proposed changes.
We are delighted that Leicester City and West Leicestershire CCGs have stepped back from proposing these extremely concerning changes. We are deeply disappointed however that Leicestershire and Rutland CCG have approved the policy, although pleased they have also delayed introducing it. The MND Association engaged closely with the proposals put forward by the CCGs, initially through a written consultation response and a meeting with commissioners in early 2017, and then a public campaign involving local MPs, a petition and pressure via social media. We would like to thank all those supporters who took the time to write to their local MP and sign the petition, and to partners such as Spinal Injuries Association, Leicester Mercury Patients’ Panel and the Continuing Healthcare Alliance.
We understand that Leicester City and West Leicestershire CCGs will undertake an impact assessment between 1 September 2017 and 20 November 2017, and reconsider the policy in January 2018. East Leicestershire and Rutland CCG will consider its next move at its board meeting on 8 August 2017. We will continue our work in this locality and resist any changes that would result in reductions to people’s CHC packages.
Nationally the Association will continue to push for an effective CHC system that fully meets the needs of all those eligible for support, regardless of where they live. Following the critical report on CHC produced by the National Audit Office in July 2017, we will write to the Public Accounts Committee to call for a full service review. Supporters interested in this area of our work can find out more and take action here.
For more information contact: Alice Fuller, Campaigns Manager (East) – firstname.lastname@example.org