Refund of £millions for Welsh patients wrongly denied NHS Continuing Care funding

Dated:

The Welsh government has ordered a review of NHS Continuing Care assessments after patients were charged for care they should have received for nothing.

Care of the Elderly

Sick and elderly people who appealed after being denied NHS Continuing Care support have already been refunded £3.6m by health boards.

With a backlog of some 2,000 more appeals to consider, millions of pounds in further refunds have not been ruled out.

It emerged in October 2011 that many elderly people have been forced to sell their homes to fund care that the NHS should have provided free of charge.

The situation has prompted the Welsh government to ask the Wales Audit Office to look into the assessment system, with a report expected in spring next year.

Although health minister for Wales Lesley Griffiths declined to be interviewed, the shadow health spokesman Darren Millar said a shorter appeals process would reduce legal expenses and that frail people are being put "through the mill" for care that should be funded by the state.

"It is heartbreaking when people have to sell the family home, which may have been in the family for generations, simply in order to meet costs of caring for a loved one.

"What we have to do is make sure there's a much shorter appeals process so that when there's a disagreement it can be resolved quickly."

Other critics claim that guidelines in the Welsh government's assessment forms, which were amended in 2010, make funding in Wales harder for some patients to obtain than in England, where the forms have not changed.

The Royal College of Nursing (RCN) in Wales says it is worried about the simplistic way in which nurses have to assess eligibility for free care.

"If you've got nurses telling you it isn't right, you've got patients telling you it's not right, and/or their relatives, then I think it's time the government listened and changed the tool," said RCN director Tina Donnelly.

"The tools themselves do not enable much discretion - it reminds me of when you've got a tick-in-a-box questionnaire being sent in about your likes and dislikes. You know that's not the answer you want to give but it's the closest to the one you are being asked."

In one case, Helen Jones from Porthcawl has told of her battle to care for her mother, Cynthia Molkner, who died in March at 83 after a 2009 diagnosis of advanced vascular dementia.

The former businesswoman and model, who was was bedridden, incontinent and unable to communicate, dress or feed herself, was twice denied funding by Abertawe Bro Morgannwg University Health Board, which said that Mrs Molkner was not sufficiently sick to qualify for free care.

Mrs Jones said she was forced to sell belongings to help fund twice-daily visits by council carers.

The board decided Mrs Molkner was entitled to free care only hours before she died.

Mrs Jones noted that her mother had followed the advice of successive governments and obtained a pension. "She paid a full national health insurance stamp, paid all of her taxes and this is how she gets repaid," Mrs Jones said.

In memory of her mother, Mrs Jones has begun a campaign, "This Could Happen To You", to change funding rules and to help other carers challenge health boards' decisions in Wales.

Abertawe Bro Morgannwg University Health Board declined to comment on Mrs Molkner's case.

NB. NHS Continuing care funding in Wales is different to NHS Continuing care funding in England.




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