National Audit Office Report on NHS Continuing Healthcare

A NAO report on its Investigation into NHS continuing healthcare funding (CHC) makes interesting / depressing reading.  The Press Release accompanying the Full Report notes that spending on CHC, NHS-funded nursing care and assessment costs amounted to £3,607 million in 2015-16 and are expected to rise to £5,247 million in 2020-21. It also notes that NHS England wants CCGs to make £855 million of savings on this figure by 2020-21.

The report confirms the view that there is significant variation between CCGs in both the number and proportion of people assessed as eligible for CHC (the CCG variation in eligibility ranged from 28 to 356 people per 50,000 population).

The report notes that the number of people receiving CHC funding ‘is rising and the funding of CHC is a significant cost pressure on CCGs’ spending’. It was reported that Norman Fowler had referred to the rise as completely ‘unsustainable under current spending plans’. What is unsustainable is the loss of beds from the NHS and its chronic lack of adequate funding. The rise in NHS CHC numbers over the last 10 years (that has now halted) reflects the bed loss during that period. The number of people receiving CHC appears to have increased by about 30,000 since 2007 – and during this period NHS England data suggests that the NHS has closed over 38,000 overnight beds (from 167,000 to 129,000).