The Department of Health has reminded us of the importance of the National Framework for NHS Continuing Healthcare and NHS-Funded Nursing Care, originally published in 2009.

The Dear Colleagues letter dated 14 July 2011 stresses the importance of ensuring that any initiatives around seeking cost saving efficiencies in continuing healthcare do not breach the legal parameters for determining eligibility for, and access to, continuing healthcare.

The letter which has been issued highlights to SHAs and PCTs the difficult line to tread when seeking to achieve efficiencies in continuing healthcare, as part of a local work stream of Quality, Innovation, Productivity and Prevention (QIPP) programmes (or otherwise), whilst at the same time ensuring eligibility for continuing healthcare is in no way adversely affected.

It notes the efficiencies that may be achievable in terms of the commissioning of the services used to deliver the necessary goods and services to those in receipt of continuing healthcare.

The guidance makes nine key points. Amongst other things it draws attention to the necessity for:  

  • procuring services in the most cost efficient and effective manner; and
  • managing provider performance by specifying outcomes, monitoring quality and ensuring sufficient clarity regarding the services being commissioned.  

The guidance suggests:  

  • commissioning from a wide range of providers in order to secure high-quality, value-for-money services;
  • wherever appropriate commissioning in partnership with local authorities; and
  • maximising personalisation and individual control; operating person-centred commissioning and procurement arrangements.  

In terms of the future the letter explains that the current Directions will be set out in Standing Rules for CCGs and Directions for Local Authorities. In addition the independent review function will go to the NCB.