Campaigners in Norfolk are promising a battle over draft plans by a local NHS body to tighten the criteria for allowing disabled people to receive continuing healthcare at home, rather than in a nursing home.
The NHS Norfolk policy sets out “nine conditions relating to clinical risk and cost” which would have to be met for it to provide healthcare at home.
One condition is that the cost of providing healthcare in a person’s home must not be more than 20 per cent more than a nursing home placement. If it is, they could be forced into an institution.
This could affect some of the 23 people in the area with the most “complex health needs” who already receive care at home, if their care has become “financially unsustainable”.
And it also seems likely that it would affect nearly every new recipient of continuing healthcare, as NHS Norfolk says the average cost of home care is nearly £8,000 a month, while the average monthly cost of a nursing home is just over £4,000.
Mark Harrison, chief executive of Norfolk Coalition of Disabled People, said the new policy was “not acceptable” and promised protests if NHS Norfolk attempted to move disabled people out of their homes and into institutions as a way of cutting costs.
He said such a move was “turning the clock back” and seemed to “fly in the face” of government guidance around personalisation.
He said: “We are going to get conflict if they try to move disabled people out of their home against their will because of the cost-cutting exercise. We are on a collision course.”
David Stonehouse, NHS Norfolk’s deputy chief executive, said the policy was based “entirely on the need for clinical safety” but that “it would be wrong for us not to address the secondary financial issues in a public consultation”.
He said: “We are pro-actively working to ensure as many patients as possible can be treated in primary care – at home or within their local community – rather than in hospitals or nursing homes and we have put in place and continue to innovate ways to keep people living independently.”
The controversy came as health secretary Andy Burnham laid out plans to carry out more dialysis in people’s homes and more chemotherapy in the community.
Burnham said the time had come “for the NHS to make a decisive shift in providing more care out of hospitals and in the patient’s community and home”.
A Department of Health (DH) spokeswoman said there was a “general wish” to have people cared for more in their own homes but “we do realise there are clinical circumstances why that might not be appropriate”.
She said NHS Norfolk would “need to defend” their plan “locally” and added: “There can be local circumstances that make it difficult to comment from a national perspective.”
Meanwhile, two disabled people have been forced to drop their court battle to force their local primary care trusts (PCTs) to allow them to use direct payments to manage their own long-term healthcare at home.
Valerie Garnham, from Islington, north London, and Steven Harrison, from Yorkshire, had argued that health secretary Andy Burnham acted unlawfully and breached their human rights by denying them the ability to manage their continuing healthcare through direct payments.
But they had to drop their appeal when the DH said that new laws under the Health Act 2009 – which will only allow direct payments for healthcare through official pilot schemes – would come into force the day before their case was due to be heard.
Disability Law Service (DLS), which was representing Garnham, said she and many other disabled people would now have to rely on their PCTs going through the “lengthy process” of applying to pilot healthcare direct payments.
A DLS spokesman said Garnham, Harrison and “a vast number of disabled people across Britain” would now be “liable to be stripped of their independence and human rights to manage their own care”.
Garnham said she was “devastated” by the thought of losing the right to use direct payments, but still hoped there might be a way to take a case against the government under the Human Rights Act.
She said: “Obviously not everybody wants direct payments, especially people on continuing care, but people should have a choice. It’s as simple as that.”
18 February 2010