NHS bungling denies care cash to thousands of most vulnerable
VULNERABLE care home patients are wrongly being denied hundreds of thousands of pounds in NHS funding, a damning report has found.
It means thousands of families may be needlessly selling their homes to pay for care.
Some have had to cover up to £250,000 in bills after being mistakenly rejected for the funds, according to the Parliamentary and Health Service Ombudsman (PHSO).
It said ‘incorrect and delayed’ decisions are having a ‘devastating impact on people’s lives’, leaving some without essential care.
More than 175,000 patients were referred last year for NHS continuing healthcare funding (CHC), typically around £1,000 a week and paid to those with complex, severe or unpredictable health needs. But 36 per cent of them were not deemed ill enough to qualify.
The ombudsman found failings in over a third of 150 cases it probed from April 2018 to July this year, meaning thousands may have been wrongly rejected.
Experts say it is often unclear how decisions are made, and many families believe the funding is removed even if a patient’s condition has deteriorated.
The Daily Mail has been campaigning for the Government to fix the social care crisis urgently, in particular for dementia sufferers. It has previously revealed that more than 1,000 seriously ill patients are being stripped of CHC funding every year.
The ombudsman criticised ‘significant’ and ‘repeated failings’ in assessments by local Clinical Commissioning Groups (CCGs), which have left families facing a postcode lottery.
In one instance, the ombudsman forced a CCG in London to pay a family £250,000 after it wrongly denied their mother funding following a stroke. It meant her family had to take on care themselves and fund an additional carer for 119 hours a week for more than two years.
On another occasion, a woman with significant care needs was incorrectly stripped of funding worth £33,000, which her family had to pay themselves until the ombudsman stepped in.
PHSO chairman Rob Behrens said mistakes had caused ‘huge suffering, as well as financial harm’ and constituted ‘an abrosaid: gation of basic rights’. He added: ‘The NHS should be supporting people in their care needs, not needlessly adding to emotional and financial burdens.’
Mr Behrens is calling on CCGs to improve communication with families and train staff to ensure decisions are made correctly.
Laura Cockram, of Parkinson’s UK, said: ‘Sadly, this report confirms what our members have been telling us for a long time – that people are being left to struggle through a complicated and unwieldy process.’
Lou Patten, chief executive of NHS Clinical Commissioners, ‘We agree it is vital individuals and families are aware of their rights and what they can expect from the process, including how to challenge a decision.
‘No one should be left experiencing financial or emotional hardship as a result of going through this system.’
An NHS spokesman said: ‘While continuing healthcare funding is available to a minority whose needs are assessed on an individual level, the NHS will look at the recommendations set out together with local health groups and the Government, who set the guidance on eligibility.’