Concern for care homes over NHS Continuing Healthcare funding


Care England, the largest representative body for independent providers of adult social care, has expressed continued concern over developments related to the funding of NHS Continuing Healthcare for care home residents.


Professor Martin Green OBE, Chief Executive of Care England says:

“NHS Continuing Healthcare (CHC) is an essential means of ensuring the primary health needs of individuals within community settings are met and much of this care is provided in independent nursing homes. Yet too many CCGs are offering increases to CHC fees for 2018/19 of only 0.1% arguing that they are required to do so by the NHS National Tariff Payment System Rules. Yet care homes face many increases in costs not least the need to pay nurses and all staff a fair wage and provide quality training to ensure they can recruit and retain good staff”.


In a recent interview with the Health Service Journal (HSJ), Ian Dalton, Chief Executive of NHS Improvement (NHSI) implied that amounts owed by NHS Trusts to the Government could be written off (5).  Mr Dalton also acknowledged that a ‘significant delta’ existed between tariff prices and actual costs, adding that this would need to be addressed.


Martin Green continues:

“Care homes offer high quality care and support for individuals with primary health needs as opposed to occupying long-stay beds in hospitals. Decisions on fee levels are important to ensure that the system works effectively and efficiently in supporting individuals within community settings. Inadequate funding places such provision at risk. Yet even those in senior NHS roles admit that the national prices determined under the NHS Tariff Payment System are unrealistic and this for us means NHSI’s rules for Local Prices (i.e. the requirement to have regard to the cost uplift and efficiency factors applicable to national NHS prices) are no longer credible. CCGs should be working with care homes to fund CHC properly. Why are CCGs not taking evidence from the sector on CHC cost increases or properly consulting? This situation cannot continue and NHS leaders should be clear to CCGs that the “national price inflator” of 0.1% is not appropriate to local prices for CHC”.



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