I have fought hard to get CHC into place for two family members with severe AD. I am informed by the CCG although they follow the CHC national framework, recent changes indicate such funding must be value for money. This will mean that my relatives, who could leave a CH and live in their own home with a suitable package of care as provided by the appropriate CCG, may now not be able to do so.
I write in the hope others may have heard similar news
Steve in Devon
I have checked my DH Circulars, and (so far) have not traced this. However, it is a standing requirement that Value for Money (VFM) is considered when making decisions as to
how care is to be provided (once the decision to grant CHC has been made). One question here is if it is clinically-desirable to pursue a particular course of action, can an alternative be pursued as it is better VFM (usually, but not allways = cheaper)? The economics of care-homes vs care at-home aren't always going to be clear cut. At its most extreme the LA rate for the nursing home (then classed as EMI nursing) where my mother ended up was around £34k+ pa, while one-on-one round the clock nursing would have been around £175k pa. (We never got to the CHC debate, as she ended up funded under s117 of the Mental Health Act.) There could be little real argument in such a cases, but the alternative of (say) a nursing home at £44k pa and a home care package at £50k pa is more finely balanced. I suspect that in most dementia cases it is likely to be the choice of nursing / care home or the care package provider that is the issue, though, rather than the care route itself. That's already the case, so I suspect the guidance mentioned is a restatement of the existing requirement rather than a new one. That isn't to say the issue highlighted by the OP won't arise - it certainly will - but I doubt that it will be the most common issue.
W
