Interesting episode on bed blocking, in ITU but by young people with specifc rehabiliation needs.
I’m going to watch again for the detail, but there seem to be finance caps even on CHC cases
Reminders of Eun and young Rob
Anyone else see it?
Finance Caps on CHC ?
Main thread :
Whole section on that aspect … cap … imposed by the NHS or the LA … suspect LA ?
Section headed " Asked to pay " Top up " fees when receiving CHC or NHS Continuing Healthcare ? "
Sub section headed " What do the rules on NHS Continuing Healthcare say about covering the cost of care ?
The National Framework says the funding package should be sufficient to meet all needs in the care plan. The CCG should base this on its knowledge of the local costs of services for those needs. It is also important that the models of support and the provider used are appropriate to the individual’s needs. And they should have the confidence of the person receiving the services.
Be interested to learn what the program has to say on this.
The above is a legal view and as far as my researches have shown , also confirmed by Professors Luke Clements and Peter Beresford.
Fairly recent Parliamentary Committee also drew attention to this … left with the NHS to sort out … I will post if needed.
Yes, made me think of Eun and Rob too. Very glad the young man with a brain injury got his place in the rehab his family wanted. However, the fact that the more expensive private rehab place lowered their fees raises the issue that they were overcharging in the first place and all the outsourcing the NHS now does, is costing more than it would, if the NHS had better capacity to provide the care, in its own rehab units? ( Rather like the expensive so called ATU’s.)
Melly1
Bump Chris
Reads as if I need to watch the program … isolate the CHC / NHS Continuing Healthcare element.
NHS outsourcing … a couple of past threads from memory … I will trawl and post links IF needed.
( Eun … Scotland … subtle differences which I have ignored in the main CHC thread … with more to come … for now. )
Having said that , I’ll keep a close eye on our two professors … bound to comment … The Guardian most likely ?
Hopefully , someone will upload to You Tube so as the remove the " BBC " element … just like when I watch Question Time on a Friday morning without fear of transgressing tv licencing laws !
I play that one with a straight bat !
If anyone subscribes to the Daily Telegraph , an article / review :
Hospital, series 4 episode 2 review : a key understanding of one of Britain’s most renowned institutions. >
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Last month the BBC screened Care, a drama about the state’s failing provision for dementia sufferers. Its author Jimmy McGovern reserved his largest lashing of sarcasm for the NHS job title known as a “discharge liaison officer”. In the latest edition of Hospital (BBC Two) there was a key role for someone working as a discharge planner. Same job, nearly the same job title, but this was a more generous treatment.
That’s all folks , I need me last shilling for the meter !
largest lashing of sarcasm for the NHS job title known as a “discharge liaison officer”.
…??
I didn’t get that impression from the programme - and really, it isn’t fair to blame the messengers. Either a hospital has sufficient number of beds for the patients it needs to treat - or it hasn’t. (Guess which folks???)
As patients/carers we only see ‘our’ pov - ie, we see ‘our’ relative ‘needing’ a hospital bed…what we don’t see is all the others queuing up. in other words we measure ‘our’ needs against how bad we are compared with how ‘good’ we could be…we don’t measure our needs against ‘everyone else’s’…
The hospital DOES see that - they therefore inevitably triage on the basis of ‘which inpatients are less bad than those at the head of the incoming queue’…
it’s not an objective decision (ie, ‘does this patient need longer in hospital’), it’s a purely comparative one (ie, ‘is this patient less worse than the one that wants their bed’)
It’s not ‘are you well enough to go home now’, it’s ‘are you less unwell-enough to go home now than the person I need to put in your bed’.
maybe every discharge officer should be trained to say to patients and famileis as they kick them out ‘Look, there aren’t enough hospital beds, nurses or doctors - put up with that, or pay more taxes - you choose, not me’.
PS - of course, if the bed is wanted by a morbidly obese, fag-smoking alcoholic that may be a different ethical discussion…
Akin to the LAs and social housing … 1 property becomes vacant , 20 urgent needs … " Who has the most need ? "
Was it ever intended for the NHS to have to make such decisions … more than occasionly with patients’ lives ?
Bottom line yet again … monies and resources ?
Housing need - depends if that is ‘self-created’ need (eg, deliberately having lots of children!). or, deliberately arriving in a country that you know will give you a free house.
as for the NHS, I think it’s pretty well attested isn’t it that when it was created the public had much lower expectations! So they didn’t expect to live very long, or be very healthy, and health care provision was scoped (and budgeted!) to that. It would be interesting to know just how much the percentage of gross income the government did spend on the NHS and how that has changed. I know the UK spends less on healthcare than many other developed countries (though of course that’s an iffy stat anyway - they spend LOADS on healthcare in the USA but vast amoutns of that is ‘ineffeciently’ spent - eg, a hospital has more admin clerks to deal with all the multiple insurance companies than it does medical staff…highly inefficient!).
The other aspect of course is that our disease patterns have changed drastically with demographics and lifestyle - most people with cancer simply died very quickly fifty years ago, now they are (sometimes!) kept expensively alive. Very few people were fat, etc etc etc
I don’t think there is any getting awaty from the brute fact that we do need to spend more of our national wealth on healthcare to meet our expectations - and, for the time being, to cope with (a) the baby boomer bulge in old folk (b) the morbidly obese/addicted etc.
The main ‘extra investment’ though of course needs to go into early intervention and prevention - but that requires a ‘double budget’ until the ‘savings’ from early intervention and prevention come through in the form of ‘less need for treatmetn’ etc etc. So no government ever wants to fork out for it.
There are also huge and complicated issues from the whole subject of health economics. Treating a sick person is expensive, but there is a ‘double cost’ in that someone in hospital is not out earning money either…nor is a prematurely dead person of course. .
Health economics ?
Oh dear , not my cancer patient with dementia conundrum again.
That belongs on another thread … main Green Paper / Social Care … best place to isolate it on.
Trouble is , it is also relevant here ?
Yup, it’s the old ‘who is worth saving’ issue. not nice. not cheap either.
Classic thread … starts off in one direction then … a crossroads … which direction should it take ?
All directions are perfectly valid.
Nothing ever stands alone in CarerLand … everything tends to interlock.
Alas , CHC was shot dead in Scotland …
they deemed it useless and wanted to give it a big long fancy title to sound more important .
aww shame bed blocking is at an all time high in Scotland that the Scottish government claimed DID NOT EXIST , then they changed tunes to “” we will wipe it out within 2 years “” , oh strike two of three never mind lets move the goal posts to …
“” this will take a bit more time “” …
CHC changed to “” Hospital based complex clinical care “” bet you’r impressed with a title like that eh.
an Elderly neighbour who was diagnosed with Huntington’s disease was deemed not to qualify for HBCC , because they had to much money … in the end they decided as a family to admit him to a local care home.
an other elderly neighbour was assessed as not qualifying for help as they could pay for their own needs.
as the social services departments within each council are to do checks to see if you get all fees paid for , or pay towards care …
they state all equipment is free , funny that . when the council came to remove dads stair lift the guy said he was supposed to technically charge us £200 for the removal , and delivery of each item.
but he was not going to because it had only just come out a week ago and no one had heard about it .
and just gave us paperwork to sign to say we accept that due to the nature of removal of the stair lift , there are holes in the stairs , wall , carpet and we could not claim compensation for damages.
Yep … picked up some very interesting postings on " CHC " as it is in Scotland.
Best left well alone UNLESS a " Braveheart " elects to match the CHC / NHS Continuing Healthcare thread
with one designed specifically for Scotland ?
I haven’t checked Wales or Northern Ireland … yet.
Wrong Brexit and … Yorkshire / Cornwall / Norfolk / Merseyside etc. etc. ?