Warehousing: Worse Than We Thought

Back in January, we exposed the shocking truth that dozens of CCGs have clauses in their Continuing Healthcare policies which could mean that they could move people away from their homes and families against their will because it costs less.

The media got on board with the story and our fantastic fans spread the word far and wide.

Belinda Schwehr gave us a crash course on legal precedent, and a petition was launched asking Leicestershire and Rutland CCG not to put a cost cap in place. The petition is still open, please sign it.
… and Belinda’s webinar is available here on her website (email us for a discount!)

We then wrote to every one of the CCGs on our naughty list…

The story continues:

2 of the CCGs wrote back. We have an open dialogue; we can’t tell you what they’ve said or which CCGs they are, but we’re really glad they’re talking to us. That’s the first step to progress, and that’s great.

More CCG policies were obtained for us by Bob Trafford, who took time out from studying for his MA Investigative Journalism at the University of London to give us a hand. Here’s the new database (Bob’s finds are marked with a B) and updated scores on the doors:

Database: CCG CHC policies v4

Scores on the doors:

FOIs sent to: 212

Replies received from: 153

Number using their own policy instead of the National Framework: 69

Number with policies which containing phrases that could be considered concerning: 58

This means that 84% of CCGs with their own policy seem to believe they have the right to move people from their homes.

Reading through all those policies, you can’t help but notice that there’s an awful lot of copying and pasting going on. Bits policy from one region have been somewhat unceremoniously plucked up and dropped into a policy from the opposite end of the country. There’s no rules against plagiarism between CCGs; this would probably be called “following established practice”, which is a sensible way to save time but a really ridiculous reason to start putting people into care homes against their will.

The alternative is that every CCG with these policies separately decided that this was a good idea. Teams of senior practitioners signed off these things, and either they didn’t read what was put in front of them by their trusted colleagues, or worse, they read it and agreed with it.

Money, I hear you cry, money is the reason they did this. They agreed because they felt there was no alternative.

Perhaps, but let’s talk about the money. We have been unable to find any public data about how much the NHS spends on residential or domiciliary care in people’s own homes funded by Continuing Healthcare. In fact, we have been able to find no local level Continuing Healthcare expenditure data at all. We have a lot of questions about the money, and at present the answer to most of them is: We don’t know.

Here’s something we do know. One policy states:
“… the CCG will place an upper limit on the cost of a domiciliary care package. Such packages will only be funded if the cost does not exceed the cost of a residential placement by more than 10%.”

Most policies say “generally”, “ordinarily”, or “usually”, leaving a possibility that they might be kind, this time. Not so the policy quoted above; you get a sense of “no ifs, no buts, no coconuts”.

A nursing home placement can cost around £450 per week. 10% of £450 would give £45 per week. Per year, 10% more would be £2,340.

Following their policy, they would move somebody to a nursing home against their will to save £2340. Apparently, freedom is not priceless. It’s worth less than a second hand Ford Fiesta.

By Fleur Perry

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