£101 nursing fee changing your weekly care home bill?

[Sally]

Hello everybody and Happy Friday!

In October the NHS decided that the nursing bands would go from three to one and everyone would have £101 to cover their nursing fees.

Opinion is divided on whether or not this ought to affect people who were on the lower or medium rate of nursing i.e.they ought to see a reduction in their weekly bill. What I want to know is whether anyone has experienced this?

Thanks
Sally.

 

[jenniferpa]

Sally - could you clarify what "opinion is divided" means in this context? I have seen nothing in print to indicate that people in receipt of this payment will not/should not have their nursing homes bills reduced accordingly.

 

[Sally]

divided opinion

At the time of the change the Alzheimer's Society and Age Concern were looking into whether or not homes ought to decrease the weekly bill of the resident due to the fact that some people's nursing fees were around £40 and £60 before the change. However, the NHS have published a document which says 'People should not see a change in their weekly bill due to the increase in nursing band'.

 

[jenniferpa]

Sally - which document is that?

I can (being the devil's advocate here) see "some" rationale for not deducting the full amount. The stated reason in the DOH documents I have seen for the increase is to keep pace with increases in nursing salaries. On that basis, the care home fees should rise and then the full amount of the RNCC should be deducted. I think it should be done this way so as to be absolutely transparent about what is happening.

"When NHS-funded nursing care was introduced in October 2001 we made a commitment to
regularly reassess the payment attached to the banding, in line with the increases in nurses’
pay. "

(from NHS-Funded Nursing Care Practice Guide 2007)

Although this is no longer my problem, I would have had to be forced by legal action to accept this interpretation without a change in the nursing home fees.

 

[Sally]

That is from the document NHS continuing healthcare and NHS funded nursing care, October 2007.

To be honest I might as well stir up the can of worms/hornet's nest/bag of vipers/you name it:
In this country there is a clear distinction between social and nursing care. People in care homes can get a break down of where exactly their money is going if they are self funding. If their nursing band changes, the breakdown of their social care bill/food/laundry/heating etc would not change one iota. The NHS does not need to subsidise people's social care bill/food/laundry/heating etc.

Furthermore, (you WILL be sorry you asked!!) how would people's nursing needs be monitored? For example, someone goes in to a home and they are on lower band nursing then the new band comes in and they get a deduction in their weekly bill because there is technically around £60 extra in the kitty. What if their nursing needs increased over the next few months to the point where they would have been on the higher band in a year's time. Would the home keep adjusting the monthly bill to reflect the nursing needs the person has?

Also, if we are to assume that people do get money off their bill when they are self-funding can we then assume that if people are being paid for by the local authority (meanwhile forfeiting their pension and benefits) that the local authority feels the benefit? In which case, who gets the 'extra' money -the local authority or the person who no longer has their state pension in full or their Attendance Allowance? Would the NHS be happy to hand money over to the local authority?

That's it I think. I will now duck behind my parapet and make a very small shape.......

 

[jenniferpa]

You're talking about this I think? http://www.dh.gov.uk/en/Publication...tions/PublicationsPolicyAndGuidance/DH_079515

I don't think it's particularly well written - I'm reasonable certain that what it is trying to say is: if your nursing band changes your fees will not change, which is correct since any increase (or theoretically decrease) in your band will be between the nursing home and the NHS (your services will change but that shouldn't make any difference). I do not think it intends to imply that there should be no change in nursing home fees due to the rebanding otherwise (JMHO) it would actually say that. It might mean that, but then I go back to my original point - not well drafted and open to (mis) interpretation).

Those are just my initial thoughts - I have to leave my computer. I may rethink this when I get back

 

[Sally]

Yes that's the document. How others have interpreted the wording is that people who were on the higher band (£139) should not experience a change in their charges but simply the word 'should' is not helpful (people with dementia 'should' not experience poor levels of quality of care - I 'should' have a husband who does more housework!! and so what? It doesn't really mean very much is what I think).

 

[Natashalou]

My mother is fully self funding and has seen no increase in the weekly reduction, its still reduced by £87 per week not £101 despite my querying this on three occasions!