NHS red tape and delays 'compromising care for seriously ill and disabled patients'

Seriously ill patients with Alzheimer’s disease and multiple sclerosis are among tens of thousands of people whose care is compromised by red tape and funding restrictions by parts of the NHS, MPs have warned.

The Public Accounts Committee has criticised NHS England for failing to ensure patients can access NHS Continuing Healthcare (CHC) funding and warned hundreds of millions in cuts being demanded put safety at risk.

In a report on the scheme, which offers extra care support for patients with significant health needs, the committee slammed “inconsistency and delays” which have seen patients die while waiting for assistance.

Support through CHC helps patients who have care needs above and beyond traditional social care support, such as washing and dressing.

It is funded by the NHS but clinical commissioning groups (CCGs), who administer funds locally, have been asked, by NHS England, to find £855m in “efficiency savings” from the budgets for CHC and nursing support by 2021.

“It is not clear how they can do this without either increasing the threshold of those assessed as eligible, or by limiting the care packages available, both of which will ultimately put patient safety at risk,” the report states.

MPs said patients were already facing significant barriers to accessing funding they’re entitled to and this was harming their health.

“Too often people’s care is compromised because no one makes them aware of the funding available, or helps them to navigate the hugely complicated process for accessing funding,” the report states.

It also says that when they do manage to navigate the process and request funding they are kept waiting.

One third of assessments, almost 25,000 cases, in 2015/16 took longer than 28 days, around 2,500 waited more than a year and the committee even heard of patients waiting up to three years for a decision.

“In some cases people have died whilst waiting for a decision,” it adds.

This is down in part to the criteria that local groups apply to the scheme, the number of people receiving CHC support varies from 28 people per 100,000, to 356 per 100,000 between CCGs.

A variation which the Government and NHS England has acknowledged goes far beyond the range in seriously ill patients.

The PAC report says that this has been allowed to pass unnoticed because of ineffective oversight of CCGs, and calls for a programme to raise awareness of CHC with patients and their families and for “remedial action” against CCGs forcing patients to wait.

PAC chair, Meg Hillier MP, said: “Conditions such as Alzheimer’s disease and multiple sclerosis have devastating effects on sufferers and their loved ones. Help with meeting the costs of on-going care can make a critical difference to their quality of life. “It is therefore distressing to see the system intended to support such people fall short on so many fronts.

“Oversight of CHC funding has been poor and NHS England’s demand that clinical commissioning groups make big efficiency savings will only add to the financial pressures on the frontline.

A spokesperson for NHS England said: “We disagree with the committee’s opinion on this, not least as CHC spending is set to increase not fall. What’s more the big differences in spending between local areas suggests the NHS is right to continue to push for efficiencies here.”