Government responds to ombudsman’s report on NHS Continuing Healthcare

In November 2020, the Parliamentary and Health Service Ombudsman published a report, Continuing Healthcare: Getting it right first time following a review of 60 CHC cases (you can read our earlier post here). Six essential recommendations were made which the PHSO saw as central to preventing similar failings for future care users.

The Department of Health and Social Care, NHS England and NHS Improvement were asked to provide an update six months after the publication of the PHSO’s report and this joint letter dated 29 April sets out how they intend to act on the PHSO’s findings and recommendations.

In this blog, we look at the DHSC and NHS E/I’s joint response to those six recommendations. But before we do so it is worth highlighting areas of responsibility:

• DHSC is responsible for NHS CHC policy and legislation
• NHS E/I oversee the ‘oversight and support’ to CCGs with commissioners responsible for the assessment and determination of eligibility for NHS CHC and the commissioning of appropriate care packages

Recommendations 1-4: care and support planning

1: Supporting the skills and experience of NHS CHC practitioners locally (for CCGs)

2: Sharing learning nationally (for NHS E/I)

3: Putting learning into practice (for NHS E/I)

4: Supporting people and providers through the NHS CHC process (for CCGs)

In its response, NHS E/I explain they expect CCGs to commission “high quality care packages making best use of resources and best value for their local populations” and to support CCGs achieve this, NHS E/I make a number of commitments which we set out below:

• Update the NHS CHC e-learning care and support planning and commissioning modules to reflect the guidance for NHS patients who wish to pay for additional care.
• Continue to promote these modules to CCGs.
• Promote to CCGs the importance of engaging with individuals, so they have a better understanding of the services that the NHS is funding to address their assessed needs
• Update the online CCG NHS CHC Assurance Tool so that CCGs can self-assess their care and support planning and commissioning processes. They explain that this will form the basis of the identification of long-term support and coaching required for individuals undertaking NHS CHC processes and for CCGs.

Recommendations 5 and 6: previously unassessed periods of care

5: Developing national guidance (for NHS E/I and DHSC)

6: Delivering capability in the NHS CHC system (for CCGs and NHS E/I)

In its response, it says DHSC and NHS E/I commit to undertake further work to better understand the issues raised by the PHSO in relation to these two recommendations. The DHSC will consider the appropriate policy response and NHS E/I will then consider any implementation issues and support, if any changes are made.

We will update readers as and when the DHSC report back following their further work in this area.