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New continuing care figures show “unbelievable” local differences

23 February 2007

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New Department of Health (DH) statistics obtained by Age Concern indicate the scale of the postcode lottery for continuing care.

The new statistics show that some primary care trusts (PCTs) – who are responsible for deciding who gets and who pays for continuing care – record over 40 times more people continuing care as a proportion of their population than others. While local anomalies explain some of the most extreme figures, it cannot fully account for the scale of the differences.

Continuing care in a care home means that it is fully-funded by the NHS, which includes all accommodation, food and nursing and personal care costs. At home, it means personal care as well as healthcare is provided free. Anyone whose “primary need for care is a health need” should be eligible – but many unfairly miss out.

Rotherham, Newbury and Community, Ashton Leigh and Wigan, Eden Valley and Central Suffolk all give continuing care to just 0.5 people per 10,000 adults – this compares to over 15 PCTs that give more than 20 people per 10,000 adults continuing care.

Some areas have worryingly low percentages of their populations getting continuing care – such as many PCTs in South Yorkshire, Nottinghamshire, Lancashire and Derbyshire.

Neighbouring PCTs – that share the same criteria from their Strategic Health Authority – have vastly different rates of people getting continuing care. For example, Doncaster Central PCT has 15 times more people getting continuing care, when taking account of its population, than neighbouring Rotherham, Sheffield South West and Bradford City Teaching PCTs.

Gordon Lishman, Director General of Age Concern, said: “The scale of this problem is unbelievable. At present, some older people, who are paying all the costs of their care, have higher needs than those who are fully funded in other areas. These figures indicate the ultimate postcode lottery.

“The government is proposing a national framework and assessment tool. The fact that such large differences can be seen, even between areas that use the same criteria now, does not give much hope that decision making will become much more consistent around the country.

“The new framework will need to be very clear and all staff (both in health and social care) will need to have training to know when to trigger an assessment for continuing care. Otherwise people will continue to miss out on their entitlement to continuing care.”