Government Response

The Government responded to this petition on Wednesday 24th July 2019

The Government does not believe there is a need for a public enquiry into NHS Clinical Commissioning Groups management of NHS Continuing Healthcare, who continue to meet their legal duties.

NHS Continuing Healthcare is a vitally important part of the NHS and is provided to some of those with the highest and most complex healthcare needs in this country. The Government is therefore committed to ensuring that any individual who may be eligible to receive NHS Continuing Healthcare is identified and assessed, and if found eligible, receives an appropriate package of care which meets their assessed needs.

The Government does not believe that NHS Continuing Healthcare is being mismanaged by NHS Clinical Commissioning Groups. The duties of NHS Clinical Commissioning Groups in relation to NHS Continuing Healthcare are set out in legislation and in the NHS Continuing Healthcare National Framework. In particular, they have a duty to assess any person who appears to have a need for NHS Continuing Healthcare and, if that person is found eligible for NHS Continuing Healthcare, to commission a package of care that meets their assessed needs. NHS Clinical Commissioning Groups are meeting these duties.

The Department of Health and Social Care is working closely to support NHS England with their NHS Continuing Healthcare Strategic Improvement Programme, which works with NHS Clinical Commissioning Groups to improve outcomes, experience, and the use of resources in the delivery of NHS Continuing Healthcare.

The number of individuals eligible for NHS Continuing Healthcare has increased from around 133,000 in 2012/13 to over 160,000 in 2018/19. Improvements are being made, for example with the latest quarterly data showing that in the last quarter of 2018/19, 70% of NHS Continuing Healthcare assessments were completed within 28 days, up from 66% in the last quarter of the previous year.

The number of NHS Clinical Commissioning Groups delivering the expected standard of 80% within 28 days has increased from 87 in the final quarter of 2017/18 to 115 in the final quarter of 2018/19.

NHS England are also working with NHS Clinical Commissioning Groups to address variation in performance and NHS Continuing Healthcare eligibility rates. To better understand the nature of variation in eligibility, NHS England has developed a clustering methodology, which groups together NHS Clinical Commissioning Groups with similar demographics. Additionally, a national programme of training has been launched to improve the quality of training for staff carrying out assessments.

NHS Continuing Healthcare eligibility decisions do have a big impact on individuals’ lives, as well as those of their family and friends, which is why it is right that there is a careful and considered decision-making process in place.
The Department of Health and Social Care is responsible for the NHS Continuing Healthcare National Framework, which sets out the principles and processes for assessment and eligibility. An updated version of the National Framework was published in 2018. This revised Framework followed an extensive period of external engagement with stakeholders and patient representative groups, and with those working within the NHS and local government.

The update incorporated a new structure to provide clarity, reflect legislative changes such as the Care Act 2014, and included minor clarifications on some policy areas. Importantly, there were no changes to the eligibility criteria for NHS Continuing Healthcare, or the extent of the service provided by the NHS.

Department of Health and Social Care.