“What’s the catch?” is the Registered Nursing Home Association’s (RNHA) reaction to the Department of Health’s announcement of an uplift in the NHS contribution paid to cover the cost of nursing provided to both local authority-funded and self-paying residents of care homes.
“We welcome the fact that a detailed review of actual nursing costs in care homes has led to an increase in the weekly amount to be paid – from £112 to £156.25,” said RNHA chief executive officer Frank Ursell.
“On the face of it, this is a step in the right direction. But we have concerns about the fact that the increase is described as an interim award, which according to the Department of Health could be reduced for some nursing home residents after further analysis of the figures.
“There are also big question marks about where the money will come from. Is the government going to make an extra allocation of funds to NHS clinical commissioning groups (CCGs) so that they can pay the money to residents being cared for by nurses? Or are CCGs expected to find this from their existing resources? And how long will be it before payment of this overdue increase and the backdated amounts stretching back to the start of April will actually be made?”
He added: “These are not the only potential flies in the ointment. A majority of patients in many nursing homes qualify for local authority funding of all their fees. The NHS contribution is intended to meet the nursing element of those costs. So will cash-strapped local authorities pass over the whole of the award to the nursing homes concerned? Or will they try to hang on to it in order to protect their hard-pressed budgets?”
“All these loose ends makes care providers necessarily cautious about the outcome of the review of nursing costs commissioned by the Department of Health, on which this award is now based. RNHA members are understandably asking questions. We look to the Department of Health to provide some answers as quickly as possible.”
The RNHA is now closely studying the report by accountancy firm Mazars on the review, including recommendations on how NHS-funded nursing care costs for care home residents should be calculated in future.
Said Mr Ursell: “Mazars have put forward a number of options. They include linking nursing costs to the general inflation index, adjusting the figure each year in line with the additional costs being incurred by care providers for employing nurses, linking the annual award to changes in NHS nursing costs, and carrying out annual surveys of nursing homes to ascertain how they are affected by cost changes. We hope that we, the care providers, will be closely consulted by the Department of Health on all these ideas.”
He concluded: “The Mazars report, which is based on a survey of nursing homes, has identified regional and other variations in costs. This is no surprise to anyone, because the cost of running a nursing home in London or the South East is necessarily higher than in many other parts of the country.
“We hope that this will not turn into an excuse for the Department of Health, some months down the line, to withdraw the uplift on a selective basis. To do that would be both disappointing and unfair, not least because in our view the NHS contribution has been unrealistically low for a long time.”