Rightsizing Continuing Healthcare in the NHS

Liaison Care Managing Partner, Phil Church, looks at the challenges for Continuing Healthcare (CHC) in the NHS, and the importance of rightsizing CHC to reduce financial deficits...

20 May 2024

Continuing Healthcare (CHC) has been flagged as a critical issue for both the NHS and Local Authorities, as well as those individuals needing social care, and their families and/or loved ones. CHC not only funds an individual’s health care – which would be free under the NHS – but also their social care, which otherwise would be means tested.

Social care costs can be very expensive, and it can make a huge financial difference to an individual whether they have to pay these costs themselves or the bill is covered by the Local Authority.

The latest data from NHSE states that more than 52,000 people were eligible for CHC as of the end of Q3 2023-24; which is 7% more than the previous quarter, and a 4% increase overall from the year before. There are a number of reasons for those increases, many individual, and some systemic. 

The challenge of rightsizing CHC post-Covid

During the pandemic, the focus for hospitals – quite rightly – was to free up beds and reduce the risk of catching Covid-19. That involved patients being moved to community settings, at pace, and with all care costs covered. In many Integrated Commissioning Boards (ICBs), the ability to recruit and retain CHC teams has been severely hampered by Covid and the pressures it placed on so many staff, and routine reviews of packages of care in a timely fashion has been one of the casualties of that resource shortage.

What we are now seeing is the fallout, where costs are spiralling in many geographies. This is financially unsustainable for ICBs, particularly when NHS deficits are increasing. More importantly, it is also negative for patients who should be receiving the right level of care, adjusted to meet their needs as their conditions change and/or improve.

The spiralling cost of CHC

Several factors affect the rising costs of care packages; one significant area is where care providers pass on higher costs, driven by economy-wide price rises and above-inflation increases in the minimum wage. There has also been a spike in the incidence of 1-2-1 care packages in care homes.

From an analysis of ICBs’ latest board papers, 29% of ICBs point to CHC and/or the increasing cost of packages of care as a driver of their current financial deficit.

How can Liaison Care help?

Partnering with ICBs and Local Authorities, Liaison Care clinically evaluates and optimises high-cost care arrangements, focusing on the needs of the individual and on improving care outcomes to promote independence and safety. Our approach guarantees enhanced quality, accountability, and effectiveness of resource utilisation, which will automatically right size CHC provision.

With potential efficiencies of 15% to 30% against agreed patient groups, this person-centred approach ensures that individuals receive an independent, detailed review that establishes the correct level of care for their needs, from which a bi-product was recurrent savings for ICBs of over £25m across the UK in 2023.

Our highly experienced and qualified clinical staff work to support local teams. We undertake detailed analysis utilising all available evidence and framework compliant best practice, and pride ourselves on placing individuals and their representatives at the heart of our process and in finalising appropriate recommendations.

For further information or a friendly discussion about how Liaison Care can support CHC at your organisation, please get in touch.

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