Continuing Healthcare: Getting it right first time Key takeaways from the Parliamentary and Health Service Ombudsman’s report

The Parliamentary and Health Service Ombudsman (PHSO) released its report, Continuing Healthcare: Getting it right first time, in November 2020. The report is the culmination of the PHSO’s review of complaints concerning NHS Continuing Healthcare (CHC) between April 2018 and July 2020. 

CHC cases are reviewed by the PHSO when they are not otherwise resolved by NHSE. The PHSO’s findings are shared publicly, with the goal of holding organisations to account and offering opportunities to learn from past mistakes. In this report, failings were identified on the part of CCGs both in the planning of care and support as well as in reviews of previously unassessed periods of care. On the former, failings in care and support planning paired with poor communication resulted in families bearing additional costs for care. On the latter, failings in reviewing previously unassessed periods of care resulted in families facing long periods of uncertainty about finances, as well as financial and reputational risk for CCGs. Getting these reviews right and ensuring past mistakes are not repeated is critical.

Having identified these failings, the PHSO made a series of recommendations, including:

• Supporting the skills of NHS CHC practitioners, to ensure that staff have the skills and experience necessary to undertake CHC assessments
• Sharing learning nationally, through a review of the current CHC learning opportunities and tools, and delivering additional educational opportunities for the workforce
• Supporting people and providers through the NHS CHC process, by ensuring that everyone involved is aware of funding arrangements and additional service requirements
• Developing national guidance for reviewing previously unassessed periods of care to clarify CCG’s obligations
• Ensuring that CCGs have the capacity to meet these obligations

The report and its findings arrive during an incredibly complex time for the NHS and CHC alike. As a result of COVID-19, the Government announced a pause on CHC reviews and assessments between March and August 2020 and implemented interim funding for hospital discharge and care placements. Throughout the pandemic, organisations across the country have been adopting various approaches but in the midst of another lockdown and ongoing pressures on the system, ensuring that review and assessment processes are being undertaken efficiently and effectively is critical – both for current cases as well as those previously deferred. 

The key to achieving this will lie in effectively implementing the PHSO’s recommended measures; ultimately it is about ensuring the specialist skills and the capacity to manage this process are in place and clear communication is maintained throughout. CHS Healthcare is uniquely placed to support this process, having provided clinical support, advice, and consultancy in CHC to over 100 CCGs, and holding the largest CHC footprint in England, with services across all 7 regions.

You can read the PHSO’s report here.