Parents accused of inventing children’s illnesses

For an earlier ‘post’ concerned families being wrongly accused of fabricating or exaggerating their disabled child’s needs – see ‘Can you cope’. A follow up, and equally disturbing, report has been covered by Radio 5 Live as ‘Parents accused of inventing children’s illnesses’. For a link to the BBC article on this click here and to listen to the programme click here.

 

NHS CHC and supine council leaders

The number of people eligible for NHS Continuing Healthcare funding (CHC) in England has fallen – again. The most recent figures[1] have just been published and show that in the last quarter there were 54,754 people assessed as eligible for support – a reduction of 1,150 over the last quarter.  Four years ago there were 63,000[2] people eligible – and since then the number has fallen by 8,246: a staggering 13%.

The situation is, in fact, even worse: since 2014 the NHS has shed 7,268 over-night beds.[3]  However, even if one ignores this loss, the impact on these reductions (on patients, families and councils) is dramatic.  If one simply focuses on social services authorities and if one assumes that they only have to fund 50% of those no longer eligible for NHS CHC[4] – it will cost each one each year on average more than £1 million.  If one includes the impact of the beds shed by the NHS, the cost is significantly more.

In 2000 the English Government accepted that it had ‘too few hospital beds per head of population compared with most other health systems’[5] and in 2013 the former Department of Health National Clinical Director for Older People’s Services said that it was fanciful to expect significant reductions in the numbers of older people in hospitals.[6] Nevertheless this is exactly what has occurred – and the figures (detailed above) are dramatic.

In the face of the unprecedented central government funding cuts that councils are experiencing, one would have expected their senior officers and members to be more than a little vocal about this highly inappropriate example of cost shunting – and yet there is not even a perceptible whimper.  What is it about local authority leaders that make them so willing to reduce care and support packages and to hike the care charges for disabled people and yet be so supine when it comes to the NHS?

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[1] See NHS England Statistical Press Notice NHS Continuing Healthcare and NHS-funded Nursing Care data Q3 2018-19
[2] NHS Digital NHS Continuing Care Activity Statistics 2014-15
[3] NHS England Bed Availability and Occupancy Data – Overnight (KH03).
[4] About 50% of care home places are funded by social services – see LaingBuisson, Care of older people. UK market report. Twenty-seventh edition, 2015.  Although more recent publically available data is unavailable it appears that there has been little change – see T Jarrett Social care: care home market – structure, issues, and cross-subsidisation (England) Briefing Paper Number 8003, (House of Commons Library 2018).
[5] Secretary of State for Health The NHS Plan 2000 Cm 4818-I (The Stationery Office 2000) – which proposed an extra NHS 7000 beds in the following four years.
[6] The phrase used by Professor David Oliver was ‘absolute la la land’ – see S Calkin Ex-older people’s tsar criticises out of hospital obsession Health Services Journal 11 March 2013.

Welsh Independent Living Grant (WILG): Policy Reversal

Julie Morgan, Deputy Health and Social Services Minister, has announced a major change to the process of winding down the WILG.  There will be (with immediate effect) a ‘pause of the transition’ to allow for revised arrangements that include:

An independent social work assessment will be offered to all former ILF recipients who are unhappy with their care and support package and would like a second opinion. This independent view will mirror the arrangements that existed under the ILF and so will restore a tripartite decision making system;

Welsh Government will provide additional funding to local authorities for the cost of independent social workers and additional care hours that may result from these independent assessments. This means that there can be no question of changes to a care and support package being a cost cutting measure;

The under pinning principle in undertaking that independent assessment is that the result should be consistent with people’s agreed wellbeing outcomes.  As there is no financial barrier, no-one need have less favourable care and support than they had under ILF.

In making her announcement the Deputy Health and Social Services Minister said that these new ‘arrangements acknowledge the historical entitlement of former ILF recipients’.

Credit must go to the Welsh Government (even at this late stage) for looking at the facts and doing the right thing.  Enormous credit must however go to Nathan Lee Davies for his extraordinary “Save WILG” campaign – enlisting the support of Welsh Labour conference, the BBC and many other key opinion formers.  The Minister also paid tribute to Nathan in her announcement.

To link to the Minister’s announcement (and Nathan’s comments) click here and to link to the BBC story of the announcement click here.

 Photograph of ‘Traeth Dinas Dinlle / Dinas Dinlle Beach’ by Richard Jones -@lluniaurich