It’s always interesting to follow up previous reports that you have been involved in – you never know quite what you are going to find. Have your recommendations been ignored, or have they been acted upon but then not delivered the intended benefits? I’m not sure which of these I would prefer less. But I’m happy to say that in my experience positive change does flow from our reports – well I would say that wouldn’t I? Follow ups, which are a regular part of the WAO approach, also often lead to some head scratching and throw up new issues and questions to get your head around. This has been the case with the follow up on Continuing NHS Healthcare or CHC for short.
CHC is at its heart quite simple – if you have complex needs that mainly require the input from health professionals, then the NHS picks up the tab for all your care package, including any care home fees. CHC is about ensuring we all get the right care, but can also impact on us financially – so it’s important that people are assessed appropriately and consistently for CHC. But in practice things can get very complicated. CHC has its own unique language, which I have needed to get to grips with. I’m a failed Welsh learner (must go back and give it another go) and my school French and Spanish have both long since disserted me. But I can still claim to be bi-lingual – in English and CHC. But the good news for those confused by CHC’s terminology is that one recent improvement that the Welsh Government has made is around public information on CHC, with simple and clear leaflets and access to these and other useful stuff online – check out www.cciss.org.uk. It was also heartening to find a range of other steps that have been taken to respond to the issues and recommendations we have made previously.
Things get particularly complicated when seeking re-imbursement of care home fees paid when you think you or your loved one was assessed incorrectly as not eligible for CHC – which, if you are fluent in CHC, are called retrospective reviews. Some health boards have picked up the baton since we reported concerns over the way they were dealing with these claims. But others are lagging behind. Which is why we now think the time is right for the Welsh Government to take a more directive approach with health boards to improve and speed up the processing of retrospective claims.
Our follow up report on Continuing NHS Healthcare can be found here. One of the findings of the follow up was that the Welsh Government has developed a range of information leaflets, but could do more to publicise them and make them more accessible. The Welsh Government has created a new website, the complex care information and support site (www.cciss.org.uk.) which contains a range of leaflets and documents relating to CHC. The can also be found on the Welsh Government website itself http://wales.gov.uk/topics/health/nhswales/healthservice/chc-framework/?skip=1&lang=en
About the Author:
Following a varied career in the private sector and in Shelter, the housing and homelessness charity, Steve Ashcroft has worked for the Wales Audit Office and its predecessor organisations since 1994.
In this time he has project managed a large number of performance audits mainly within the health and social care sector, and within mental health in particular.
Steve is now a manager within the national studies team with a broad range of projects across the public sector.