NEWS RELEASE FROM THE
REGISTERED NURSING HOME ASSOCIATION
28th January 2002
NURSING HOMES SAY THEY ARE 'SCAPEGOATS'
FOR CHRONIC UNDER-FUNDING OF CARE FOR NATION'S OLDER PEOPLE
Nursing homes are being singled out as 'scapegoats' for the chronic under-funding of long-term care for older people, the Registered Nursing Home (RNHA) said today.
Responding to media reports that some homes have put up their fees since October to coincide with the introduction of Government payments for nursing care, the RNHA says the vast majority of homes are struggling to survive as their costs rise far faster than income.
According to the RNHA, many homes had deferred much-needed fee increases deliberately until October in order not to cause problems for those patients funding their own care (about a third of all nursing home patients across the country). This was despite the financial difficulties already faced by homes having to meet higher wage bills and other inflationary pressures.
During 2001, nursing homes have seen pay bills rise substantially above the rate of inflation, following a Government pay award of up to 11 per cent for qualified nurses and a 10 per cent increase in the national minimum wage.
The deferment of fee increases, says the RNHA, was intended to help self-funding patients avoid having to find the money until the Government started to pay for their nursing care on 1st October. Under the new scheme, local health authorities are supposed to pay a specific sum to cover the nursing costs of the care provided to this group of patients.
However, the RNHA is highlighting the fact that, in some places, health authorities have not paid out a single penny so far. Nursing home managers blame bureaucratic delays in assessing whether patients qualify for the higher, middle or lower band of payment to cover their nursing costs. It would have been less cumbersome, the RNHA insists, for a flat rate payment to have been introduced which did not necessitate such a long-winded assessment process.
Commented RNHA chief executive officer Frank Ursell: "It is perhaps not surprising that some or all of the additional payments being made to homes are swallowed up by rising costs. Given that the number of nursing homes in England fell by 650 between 1998 and 2001, with a net reduction of nearly 22,000 beds, it is obvious that many homes have been losing a lot of money."
The RNHA points out that, for the average nursing home patient, the Government has costed nursing care at no more than £10 a day. In some instances, it pays as little as £5 a day. This, says the RNHA, greatly undervalues the nursing contribution to care and adds further to the financial pressures on nursing homes.
Added Mr Ursell: "It should not be overlooked that the Government chose to ignore unanimous advice from its own multi-agency steering group, including an RNHA representative, that the payments for nursing costs should be made to the patients themselves and not to the nursing homes.
"If it had accepted that advice, nursing homes would not have been placed in the invidious position that they are now in, with accusations that they are 'pocketing' the money. We would have preferred the patients to receive the money and then to pay their nursing home whatever fee increases may have been in the pipeline. As it is, the nursing home has had to do things the other way round by deducting the fee increase from the money it receives directly from the health authority."
The RNHA believes the root of the problem for most nursing homes is that the income they receive from social services departments for State-funded patients is too low to cover their costs. On average, they get around £340 per week, despite the fact that an independent survey conducted in 1998 for the Rowntree Foundation suggested that, with a national minimum wage fixed at £4.00 an hour, nursing homes' costs would work out at just under £370 per week.
Said Mr Ursell: "The Government has been told time and time again, not just by us but by others, that the nursing home sector cannot make ends meet. It expects a nursing home to deliver everything to older people for a third of the cost of care in the long-stay ward of an NHS hospital. It cannot be done."
The RNHA would like to see the introduction of a national minimum fee for nursing home care. "In such circumstances, we would accept independent arbitration as to what that fee should be," said Mr Ursell.
END
For further information, please contact Frank Ursell, chief executive officer, RNHA
(Tel: 07785 227000 mobile or 0121-454 2511 office)
Notes to editors:
1. From 1st October 2001, self-funding patients in nursing homes (around 43,000 in total) became entitled to free nursing care. From 1st April 2003, patients whose nursing home costs are otherwise met by local authority social services departments will also become entitled to an NHS contribution to cover the 'nursing care' element of their care.
2. Under the scheme, local health authorities pay nursing homes an amount for each of their self-funding patients which, depending on an assessment of the patients' level of nursing need, works out at £35 a week, £70 a week or £110 a week.
3. A multi-agency steering group set up by the Government to advise on the introduction of the 'free nursing care' scheme, which included a representative of the RNHA, recommended that the payments should be made directly to the patients receiving the care. The Government did not accept this advice and, as a result, the payments are being made directly to the nursing homes.
4. The multi-agency steering group also advised the Government to stick to an across the board figure of so much per patient per week rather than having three separate bands. This would have avoided the need for a complex and time-consuming assessment process to determine which band every patient falls in. Delays in assessments are slowing down the system, whilst the appointment of staff to co-ordinate and undertake the assessments is consuming a proportion of the resources that could otherwise have been allocated directly to patient care. Whilst the Government rejected the advice of the steering group to avoid these pitfalls in England, the Welsh Assembly has agreed to a single figure of £100 per patient per week to cover nursing care costs. This will make the system in Wales more streamlined than the system in England.
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