Deflated Offer From The NHS

Care England, the largest representative body for independent care providers for adult social care has said it is “bemused” by a number of NHS Clinical Commissioning Groups (CCGs) only making 0.1% fee uplift offers to support people with primary health conditions within nursing homes for 2018/19.  This funding is known as Continuing Healthcare, or CHC, and is designed to fund nursing care need for individuals with complex health conditions within nursing homes as opposed to treating individuals within hospitals as long-stay patients.

The full picture of CCG fee offers are not yet fully known, but a number of CCGs have to date  made offers of  only  an  0.1% uplift for 2018/19, which takes no account of rising pressures, such as increases in staffing costs. Failure to pay at the true cost of care is placing many nursing homes at risk of closing, impacting upon individuals and their families – and furthering the pressures in over-stretched  local hospitals. Data from CQC indicates that over 4,000 nursing home beds were lost to the sector over the last 2 years.

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

“The NHS must be realistic in how it supports individuals with health conditions within the community. Low fee offers just simply adds to further pressures in NHS hospitals, and sets the scene for another winter crisis in 2019”.

Under the NHS Tariff rules, NHS organisations received a 2.1% uplift in 2018/19, but with a 2% efficiency factor reduction. Providers continue to be frustrated by the number of CCGs that remain unwilling to engage with them in meaningful negotiations on Local Prices for CHC on the basis that they (mistakenly) believe that they are mandated to apply the same  2% national efficiency  deflator  applicable to National Prices under the National Tariff Payment System (NTPS). The NTPS Guidance for Local Prices makes it clear that commissioners must consider all relevant factors (of which “having regard” to the National Price cost inflation and efficiency factor is just one).  These relevant factors include the effects of National Minimum Wage, the National Living Wage and other changes in legislation (e.g. Apprenticeship Levy, Workforce Pensions etc).

Concerns over how CHC is being applied nationally was subject to a Public Accounts Committee Inquiry and there remains ongoing concerns over the Government response to the Inquiry. A debate was held in Parliament earlier this week brought forward by Chris Evans Member of Parliament for Islwyn who notes:

“The Government’s response to the Public Accounts Committee’s recent inquiry is deeply concerning. I brought this debate forward in order to gain more clarity from the Government on their revisions to the National Framework for CHC. The Government need to assure patients that quality of care packages and levels of support are not compromised in favour of saving money and hitting waiting time targets”.

 

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