Spinal Injuries Association response to House of Commons Public Accounts Committee report on NHS Continuing Healthcare funding

The Spinal Injuries Association welcomes the report published by the Public Accounts Committee (PAC) on NHS Continuing Healthcare funding (CHC). We thank the Public Accounts Committee for its scrutiny of NHS Continuing Healthcare which provides vital life-sustaining and ongoing care and support for the most severely disabled people – including many paralysed people who have a spinal cord injury. The report rightly holds NHS England to account for its failure to ensure that NHS Clinical Commissioning Groups (CCGs) meet their legal responsibilities to provide appropriate CHC care for the most severely disabled people. Critically, the Committee is also concerned that cuts planned by NHS England of £855 million from the national CHC spend by 2020-21 will restrict access to essential care for these highly vulnerable people and/or lead to fewer people getting the essential care they need. 

The report highlights serious shortcomings in the eligibility assessment process for NHS Continuing Healthcare which have created widespread regional variations  – a postcode lottery of CHC care – in how eligibility criteria is applied, lengthy delays in assessments and in organising care, and a complex, difficult to navigate system that fails the most vulnerable when they need care and support. Most importantly, the PAC has demanded that NHS England explain how CCGs can make the planned efficiency savings of £855m by 2020-21 without restricting access to care, either by increasing eligibility thresholds or by limiting the packages of care available.

Sue Browning, Chief Executive of Spinal Injuries Association said.

“The Public Accounts Committee report into NHS Continuing Healthcare accurately reflects the experiences of our members. We are hearing depressing and alarming accounts of cuts to the size of CHC funding that is reducing care provision to unacceptable and unsafe standards. There are instances of overnight care being removed and we are receiving examples of people who have been threatened with a move out of their own home and into residential care, due to CHC budgetary constraints. The tremendous pressures that this broken system places on the most severely disabled people will only get worse if NHS England carries through its plans to make £855 million of cuts which, as the PAC notes, lacks detail and has the real potential to put people at risk by forcing them to live with unsafe levels of care. 

We are calling on NHS England to accept and act on all of the recommendations made in the report. We look forward to the NHS England report to the PAC by April 2018 on how it is addressing the serious deficiencies raised and are committed to working with NHS England to create a fair and legal process. The patient’s needs must be at the centre of decision making so that severely disabled people have a CHC system that genuinely engages with them to provide the independence, care and support they need and deserve.”

A full copy of the report can be found at https://publications.parliament.uk/pa/cm201719/cmselect/cmpubacc/455/45502.htm