The story so far

June 2007

The Department of Health in England published a new National Framework of eligibility criteria for NHS Continuing Care for use in England.

Alzheimer's Society launches new NHS continuing care volunteer support network made up of people who have won continuing care cases. The network can offer support and advice to people who are already in the process of being assessed for continuing care or are appealing decisions.

March 2007

The Ombudsman found the Department of Health guilty of maladministration for their failure provide adequate guidance to PCTs on paying back care charges wrongly paid out by people who should have received continuing care.

January 2007

Alzheimer's Society campaigner Mike Pearce wins his case for continuing care for his late mother Ruby.   Read more about Mike Pearce's case here.

November 2006

Patricia Hewitt agrees that there needs to be a national debate on charging for care to find a better system, following a visit to the Leicestershire and Rutland branch of the Alzheimer's Society.  Read more about Patricia Hewitt's visit here.

October 2006

The Department of Health announces transitional arrangements for NHS continuing care cases awaiting the publication of a final framework on NHS continuing care.

August 2006

The Alzheimer's Society responds to the Government consultation on the proposed framework for NHS continuing care.  Download the Alzheimer's Society's response.

5 March 2006

Panorama

Panorama produce a documentary highlighting the confusion and turmoil surrounding the issue of continuing care. Age Concern, the Alzheimer's Society, Help the Aged and the Royal College of Nursing are campaigning for the Department of Health to issue clear and effective guidance on fully funded NHS care. The organisations have produced their own 'Guide to Fully Funded NHS Care' which helps people better understand the issue.

February 2006

Public consultation on national framework announced

Department of Health in its update of the RNCC bands states that public consultation on the national framework will begin in April 2006. It also indicates that one rate of payment for nursing is being considered rather than the three current bands.

January 2006

Grogan Case

Mrs Grogan argues that there is a misconception that a person would only be eligible for continuing care when they exceed the highest RNCC band. She argues that this is not Coughlan Compliant and takes her case to court. The court agrees, finding the local criteria 'fatally flawed' and that the Department of Health guidance could lead to an incorrect approach being applied. He found the criticisms of the Ombudsman and Health Select Committee 'justified' and urges the DH to provide clear direction to rectify the situation.

November 2005

Letter to all Strategic Health Authorities

The Department of Health in the week prior to the hearing of the Grogan case issued a letter to all SHA's asking them to ensure they follow the correct processes regarding the high band of nursing, and make sure they have properly assessed for continuing NHS care first.

April 2005

Health Select Committee

The House of Commons Health Select Committee publish a damning report on the government's policy on NHS continuing care saying 'it seems we are no closer to a fair and transparent system'.

2004

National approach promised

The government published its own research into the process of the reviews, and found similar weaknesses to those found by the Ombudsman. The government promised to commission the development of a national consistent approach.

2004

Ombudsman report

In a short follow up report the Ombudsman was highly critical of the process of the reviews finding it 'largely hit and miss'.

2003 onwards

Retrospective reviews

Many thousands of people put in claims for retrospective funding. There were many complaints about the process for carrying out reviews, the reasonableness of the decisions reached and delays in providing agreed restitution.

2003

Ombudsman report

The Health ombudsman published a report into NHS continuing care. She found that some strategic health authorities (SHAs) had interpreted criteria wrongly. She recommended all SHAs should review their criteria to ensure they were Coughlan compliant and cases since 1996 should be reviewed. She was critical that the 2001 guidance gave no clearer definitions and was in some ways weaker than the previous guidance.

2001

NHS Payments for nursing care and Department of Health Guidance

A new system is introduced in nursing homes whereby the NHS makes contributions to the cost of a 'care package' for care delivered by a registered nurse. The criteria for the high band uses terms such as complex needs requiring frequent technical/mechanical/therapeutic interventions over 24 hour period and their physical mental health state will be unstable and/or unpredictable. This creates confusion between when a person is eligible for continuing care (where all needs are funded by the NHS) or nursing care (when the NHS makes a contribution to cover nursing care).

2001

Department of Health guidance

New guidance replaces earlier guidance. Concepts of the nature or complexity, or intensity or unpredictability (or and combination of these needs) of an individual's health care needs.

1999

Department of Health interim guidance

The government ask SHA's to check that their criteria are 'Coughlan compliant' and indicate that further guidance will follow later that year.

1999

The Coughlan case

The Court of Appeal rules that Ms Coughlan's health authority's eligibility criteria for NHS continuing care funding were unlawful. The court criticises the national guidance finding it 'unhelpful' and sets out a test for deciding when the NHS should pay for care in settings outside hospital.

1996

Introduction of Department of Health guidance about eligibility criteria

All health authorities are now required to have developed local eligibility criteria within the Department of Health guidance which specify who is entitled to fully funded NHS continuing care, and who is not (ie who must pay via the social services means test). These criteria have varied around the country, creating a 'post code lottery'.

1994

Health Ombudsman report

The Health Ombudsman issue a special report following concerns that the NHS had withdrawn too far from providing non-acute services.