Last week the BBC aired the second, and final instalment, of the documentary “Inside the Care Crisis with Ed Balls.”
Inspired by witnessing the care that his own mother is in receipt of within a care home, the former Shadow Chancellor of the Exchequer examined a range of issues which are contributing to the current crisis in adult social care. From the low wages of care staff and the lack of progression having a detrimental impact upon the appeal of the social care profession as a career, to the gap between the care provided in care homes and that which is actually funded.
Over the course of the 2 programmes viewers were introduced to Frank, a resident at Saint Cecelia’s Care Home in Scarborough. Frank was assessed as requiring one to one care as a result of the number of falls that he was experiencing at night. Frank’s niece, Jenny, explained that the cost of providing Frank with the one-to-one care that he required was approximately £15,000 a month and that this care was being funded from the proceeds of the sale of Frank’s home. Jenny explained that as this could no longer be afforded, the provision of Frank’s one to one care had to stop, and it was very clear during the programme the detrimental impact that the withdrawal of the care had upon Frank.
Jenny also explained during the programme that an application had been made for Frank to receive continuing healthcare funding, that this had been denied and that the Health Authority considered Frank’s case “closed.” What was not clear from the information provided during the programme was whether Frank or Jenny had been given the opportunity to appeal the negative decision that had been made in respect of Frank’s eligibility for continuing healthcare, which certainly should have been the case. On communicating a negative decision regarding continuing healthcare eligibility, the National Framework makes it clear that individuals and/or their representatives should be informed of their right to appeal the decision and for their appeal to be progressed, initially, as part of the Health Authority’s local appeals process. Once this appeals process has been exhausted, an individual then has the right to submit a further appeal against a negative decision to NHS England and to request that an Independent Review Panel be convened to consider the negative decision further.
During the second programme, discussion was also had regarding the Decision Support Tool document that is used as part of the assessment by the Health Authority to determine an individual’s eligibility for continuing healthcare. The different “care domains” within the Decision Support Tool were examined, which range from a person’s breathing needs, their nutritional needs, medication needs and so on and the fact that an individual is awarded a level of need in respect of each of these care domains. Mr Balls’ conclusion of Decision Support Tool document was that, for a lay person, the assessment process is so complicated that it is impossible to understand the reasons for decisions regarding continuing healthcare eligibility.
Unfortunately, this is a conclusion that is echoed by many of our clients within the Nursing Care Department at Hugh James; that the assessment process for continuing healthcare is littered with medical terminology with little explanation being provided regarding the eligibility criteria that has to be satisfied in order for eligibility to be secured. Essentially, that is a major factor as to why our clients choose to instruct us; to be represented in a process that at times can be extremely confusing and arbitrary.
Mr Balls must be commended for creating this documentary series and for again shining a light on the problems contributing to the current adult social care crisis. But, as Mr Balls highlighted, the Coronavirus Pandemic exposed a system that has been struggling for years and it was highlighted during the programme that £10 billion a year would be needed to stabilise the adult social care system. The recent government reforms through the proposed tax rise will generate a £12 billion a year but most of this will be earmarked for the NHS with just £1.7 billion a year to be allocated to adult social care. With such a shortfall in funding set to continue, the question remains as to how much more needs to be done to bring the issues faces within adult social care to the government’s attention so that the reforms that are so desperately needed are actually implemented.
