Extra Care and free Nursing Care
I am on the steering group of the Lichfield Extra Care Retirement Village and of course as Social Care & Health we are active partners in this development which is central to the governments agenda for older people. The village will have around 120 units for sale, rent and mixed tenure. it will cater for people at 5 different levels of care including those with nursing needs that require more than can be provided by District Nursing Services. This is about offering choice to people as to the environment in which they receive their care if their health deteriorates.
It is also about people being able to remain in their home should they deteriorate over time and require nursing. This is where we have hit a snag. The PCT will not invest in this service because they feel it would be inequitable to the rest of their population. They are happy to provide DN services on the basis they do now but when some people have reached a certain level they will have to be transferred to nursing homes.
My view is that these are people who would be eligible for nursing care anyway. If they were not managed in this environment they would be eligible for the Free Nursing Care payment following the proper assessments.
This way the PCT do not have to make any extra investment into the service. I whether Free nursing care funding could be used in this type of setting. Given the Government's push for more Extra Care housing it would be absurd if it was not possible but I would be grateful if someone could help us resolve this.
It would be a great pity to lose this opportunity to develop something new and innovative for Staffordshire. I believe their are other schemes who do this in Warrington and somewhere else up north!
Jackie Owen
Principal Officer (Older People)
Staffordshire County council
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From the various e-mails, the stance of the NHS does appear to be a little narrow and inflexible in this case. They should be working in partnership with social services to ensure that people's needs are met in all settings. The Health and Social Care Act 2001, as well as setting out the arrangements for NHS funded nursing care, also placed the responsibility for nursing firmly on the NHS. There should be as much choice available as possible and, as far as possible, value for money.
The provision of extra care housing will mean that fewer people will need to go into care homes providing nursing care and so there should be a trade-off between the existing budget for NHS funded nursing care and any new provision. This should be jointly commissioned across health and social care as it increases the choices that are available to people and is in line with providing care closer to home. Otherwise, all existing provision will be set in stone.
The NHS has a responsibility to meet the nursing needs of people regardless of the setting, and that would include the nursing needs of people in extra care housing. While, since 2001, a specific NHS budget has been set aside for nursing care care homes, as long as the NHS meets the needs of those for whom nursing care in acare home is appropriate, there is nothing to stop them using part of the budget - or other NHS sources of funding - for
investment in nursing care in other settings.
John Crook
Care Services Directorate
Older People and Disability
Department of Health
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