Thorough review of NHS Continuing Care needed


NHS -Care Industry News (250 x 101)Wide variations in the provision of NHS continuing care funding for people with dementia have been uncovered in a new report by Sally Keeble, former MP and Labour prospective parliamentary candidate for Northampton North.

NHS continuing care is a funding package to provide free health care for people with severe health needs.

Ms Keeble surveyed 162 Clinical Commissioning Groups (CCGs) and found that:

  • There is a lack of funding for advocacy services to provide help and support for families applying for continuing healthcare support. Only four CCGs identified specific funding for advocacy
  • The role of family carers in the decision-making process is frequently unclear
  • Training of assessors is variable, with six CCGs saying they did not provide any training

The report calls for a review of how Clinical Commissioning Groups (CCGs) assess people for continuing healthcare funding to protect against a postcode lottery.

Jeremy Hughes, Chief Executive of Alzheimer’s Society, said:

‘People with dementia can often require round the clock care, putting huge strain on families and individuals both emotionally and financially. The financial support provided by NHS continuing healthcare is a lifeline for people with dementia and their carers.

‘Callers to our Dementia Helpline tell us that applying for continuing healthcare for a loved one with dementia is a minefield. All too often we hear of families who are refused funding because their local Clinical Commissioning Group (CCG) does not adhere to proper process.

‘It is entirely unacceptable that there is no duty on CCGs to fund advocacy services – which are essential to support families through the complex assessment process. A thorough review of NHS continuing care is needed to ensure vulnerable people are not unfairly disadvantaged by a flawed and poorly implemented system.’


  1. I welcome Sally Keeble’s report.

    Firstly, it is a total postcode lottery. The variations are huge within counties, let alone between counties and different parts of the country. Largely the difference is likely to be about funding streams, but it is also about such things as commitment to elderly care, dementia and the disabled.

    Secondly as for dementia specifically, there is still a bias towards physical health, not mental health, unless it is a ‘mainstream’ mental health condition such as schizophrenia, bi-polar disorder, etc., and in my view, dementia is still often not taken seriously, consistently.

    Thirdly, even mental health services are very limited and declining. I recently asked for psychotherapy input for a gentleman who has been depressively suicidal, and not only had the community psychiatric nurse discharged this gentleman from their case load, the idea of psychotherapy input was virtually laughed at as being non existent for people living in care homes. However, these are people who often face complex conditions, have already given up their own home, (the holy grail of all community support), and often have depression for a wide variety of understandable reasons.

    Fourthly, and perhaps the biggest challenge is that whatever the need, it is unlikely that any CCG will fund the entire cost of meeting a persons holistic needs. Invariably fees are set at an arbitrary and low level, providers are told to take it or leave it, and / or face being ostracised.

    The entire system is inconsistent from less than adequate to poor to dismissive. Yet, conversely, if something goes wrong, the very same people sit piously at safeguarding meetings pouring over every detail, and asking why did you not do this or that, make better and more detailed records, and the real kicker – spend more time with people (which is laughed at when you seek funding.

    Such duplicity in poor Health and Social care commissioning practice is at the root of everything that is wrong, with challenged Hospitals, Care Homes and Care at Home.


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