Issue - meetings

Report, presentation, information given at Barking & Dagenham Health Scrutiny Committee and response from Chair, Barking & Dagenham Health Scrutiny Committee attached.

Following a referral from the Barking & Dagenham Health Scrutiny Committee, Continuing Healthcare was defined as NHS care for patients assessed with a primary health need. Eligibility of patients for this type of care was reviewed annually and this was current received by 149 patients in Barking & Dagenham, 181 in Havering and 175 in Redbridge.

The CCGs intended to introduce a placements policy in order to help them make decisions about the location of Continuing Healthcare Packages (e.g. at home or in a care/nursing home). This would apply to all new patients eligible for Continuing Healthcare and a small number of existing patients whose care needs had changed considerably since their last review. The number of patients expected to be affected in the local BHR boroughs was estimated to be 20-25 per year. The overall eligibility to receive Continuing Healthcare would not change.

The policy to be introduced would mean that a home care package would not be funded if this cost was in excess of 10% more expensive than the cost of the equivalent package in a care or nursing home. An appeals process would be available against any such decisions. A consultation on the policy had run from 8 July to 30 September 2019 and the main themes of responses had covered signposting of support, the impact of the potential separation of family members and the maintenance of personalised care. A final decision on implementing the new policy would be taken by the CCGs on 28 November.

Members felt that the consultation documents had been difficult to follow and that patient choice was being disregarded by the new policy. It was that people may be forced to go into care even though many elderly people fared better in their own homes. Other points raised by the Committee were that Local Authorities should be represented on the appeals panel and that the 28 day window for an appeal was too short given CCG rates of response to correspondence. It was also felt that the 10% threshold should not apply for people approaching the end of their life.

In response, officers confirmed that all feedback would be considered and that the make-up of the appeal panel would be reviewed. It was possible that the final policy would have a threshold larger than 10% and it was confirmed that this would not apply to people at the end of their life who wished to die in their own home.

Members also raised concerns at the impact on people having to enter care homes. It was questioned what quality assurance systems would be used for care homes and how many homes used for Continuing Healthcare were rated as inadequate or requires improvement. Other issues raised included that care should be provided at home where possible and that it was unclear patients would be allowed to attend any appeal and if the decision making meeting on 28 November would be held in public.

It was agreed that the clerk would draft a letter giving  ...  view the full minutes text for item 12