NEWS RELEASE FROM THE
REGISTERED NURSING HOME ASSOCIATION
Issued 20th February 2003
HEALTH OMBUDSMAN’S RULING ON BOLTON WOMAN EXPOSES
THE ‘LOTTERY OF NHS FUNDING FOR LONG-TERM CARE’
Today’s ruling by the Health Service Ombudsman that a Bolton resident (now deceased) who could not speak and had to be fed by tube 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 Bolton resident and her family are never experienced again, either in Greater Manchester 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 as this Bolton patient 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.
“This case shows just how big a lottery it is. Whilst Wigan and Bolton Health Authority, where the patient originally lived and which was responsible for her care, took the view that she did not qualify for funding in a nursing home, the Health Authority where the nursing home was located took the view that, if it had been responsible, it would have paid for her. What a crazy system we are lumbered with.”
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 Bolton 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 be 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 Bolton resident against the former Wigan and
Bolton Health Authority and Bolton Hospitals NHS Trust. The Health Authority
had refused to fund the cost of nursing home care provided to his mother at a
nursing home in Kent to which she was discharged from the Trust’s stroke unit
in May 2000 in order to be close to her son. She was unable to speak or swallow
and had to be fed by means of a tube inserted directly into her stomach.
3. The Ombudsman upheld the complaint and recommended that new Greater
Manchester 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: 01210454 2511 or mobile 07785 227000
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