NEWS RELEASE FROM THE
REGISTERED NURSING HOME ASSOCIATION
Issued 20th February 2003
HEALTH OMBUDSMAN’S RULING ON DORSET MAN
EXPOSES THE ‘LOTTERY OF NHS FUNDING FOR
LONG-TERM CARE’
Today’s ruling by the Health Service Ombudsman that a Dorset resident (now deceased) who suffered from Alzheimer’s disease should have had all his 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 Dorset resident and his 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: “In this case, it seems that the then Dorset Health Authority took the view that anyone receiving continuing care outside an NHS hospital was not entitled to have their care paid for by the NHS.
That 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.
“We need 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.”
The RNHA believes it is wrong in principle and in practice for health authorities to adopt the line that NHS-funded care can only be provided in NHS-run institutions.
“The NHS does not necessarily always have the capacity and the facilities to be able to provide all the types of care that are needed,” said Mr Ursell. “Nursing homes offer a more user-friendly and appropriate environment than hospitals for patients who need to be nursed for many weeks, months or years. The Government says it wants all parts of the health care sector to work in partnership. But, as this case from Dorset shows, the spirit of partnership is not always in evidence.”
He concluded: “There are lessons to be learned nationally, as well as locally, from the Dorset 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.”
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 Dorset resident against the former Dorset
Health Authority and Dorset Healthcare NHS Trust. The Health Authority had
refused to fund the cost of nursing home care provided to his father, who suffered
from Alzheimer’s disease and was admitted to a home in December 1997.
3. The Ombudsman upheld the complaint and recommended that the new Dorset and
Somerset 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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