NEWS RELEASE FROM THE
REGISTERED NURSING HOME ASSOCIATION
Issued 20th February 2003
HEALTH OMBUDSMAN’S RULING ON BERKSHIRE WOMAN EXPOSES
THE ‘LOTTERY OF NHS FUNDING FOR LONG-TERM CARE’
Today’s ruling by the Health Service Ombudsman that a Berkshire resident (now deceased) who suffered from dementia and needed one-to-one attention as her condition deteriorated should have had all her nursing home care costs met by the NHS has been described as a ‘wake up call’ to the Government.
The Registered Nursing Home Association (RNHA), Britain’s largest organisation representing nursing homes, is calling on the Department of Health to ensure that the problems faced by the former Berkshire resident and her family are never experienced again, either in the county or elsewhere.
The association claims the case highlights the bureaucratic minefield through which very sick people may be forced to tread, with some local NHS services doing their utmost to avoid assuming financial responsibility for the care costs of patients with long-term nursing needs.
The RNHA’s chief executive officer, Frank Ursell, commented: “It is incredible that someone with such intense nursing needs for a progressively worsening condition affecting her mental and physical health should not have been regarded as eligible for NHS funding when she was transferred from a hospital to a nursing home. It seems that in this case there was an extremely narrow and incorrect interpretation of the law and Department of Health guidance. It smacks more of an accountant’s ‘bottom line’ philosophy than one based on what is right for an individual patient.”
He added: “For far too long the decisions made about whether individuals being cared for outside hospital do or don’t qualify for NHS funding have been subject to the vagaries of criteria drawn up and interpreted by health authorities apparently more concerned about their budgets than about patients’ needs and rights. It makes the whole thing into something of lottery.”
Now the RNHA wants the Department of Health to ‘knock some heads together’ and make it clear that the NHS must meet all its obligations when patients have complex and long-term nursing needs.
Said Mr Ursell: “There are lessons to be learned nationally, as well as locally, from the Berkshire experience. We need a more transparent, more consistent application of national guidance about what citizens can expect when their health care is provided outside the NHS but in circumstances where the NHS should foot the bill.
“At the moment, there are too many loopholes which allow local health services to get out of their obligations and to adopt a highly subjective approach to whether they do or don’t pay up. That makes patients and their families very vulnerable to being messed about. ”
END
Notes to editors:
1. The Health Service Ombudsman’s Report on NHS Funding for Long-Term Care
was published today (20th February 2003).
2. The above report contains detailed findings by the Ombudsman on a complaint
made by the son of a now deceased Berkshire resident against the former Berkshire
Health Authority, which had refused to fund the cost of specialist nursing home
care provided to his mother after she was discharged in August 1998 from
Wallingford Hospital. She suffered from a progressively worsening condition
known as vascular dementia. She was also hurt by a fall while in hospital and
later underwent hip surgery.
3. The Ombudsman upheld the complaint and recommended that the new Thames
Valley Health Authority review its eligibility criteria for assessing whether
the cost of long-term care should be met by the NHS. The Ombudsman further
recommended that the new Authority determine whether there are any patients,
including the individual concerned in this particular case, who were wrongly
refused funding for continuing care and make the necessary arrangements to
reimburse them.
For further information and comment, please contact:
Frank Ursell, Chief Executive Officer, RNHA
Tel: 0121-454 2511 or mobile 07785 227000
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