Continuing Healthcare Assessments: the case for independent advocacy

4 November 2020

Offering advocacy to everyone who has a continuing healthcare assessment is a simple, cost-effective solution

Lauren Stoner, Director of External Engagement, VoiceAbility

The PHSO report on continuing healthcare highlights the challenges people face in accessing ongoing care for long-term complex health needs. The report shows how complaints about continuing healthcare assessments provide vital learning to drive required change and ensure that people’s rights are upheld and their voices are heard.

The PHSO highlights that:

  • far too many people are forced to self-fund vital care, or go without, due to failures in care and support planning
  • people are unaware of their rights, and of how to challenge decisions
  • people are not told clearly, or quickly, whether previous care was eligible for continuing healthcare

The report recognises that coronavirus has put great pressure on the NHS and that continuing healthcare assessments were paused for several months to free up essential frontline capacity. Now that assessments have restarted, CCGs must ensure that people do not wait too long for decisions about their care, whilst also taking crucial steps to improve care and support planning. We believe that expanding provision of independent advocacy is one powerful way to do this. 

It is an indictment of the system that so many continuing healthcare assessments result in complaints. But we already know what we need to do to make the system work better for people. Greater involvement of the person and their loved ones and better care and support planning would go a long way towards improving people’s experiences. Independent advocacy enables this.

By making independent advocacy available for people throughout the process, CCGs would ensure that people understand their rights and are supported to exercise them. This would lead to better outcomes for people and reduce complaints and appeals which cost CCGs hundreds of thousands of pounds every year.

Right now, CCGs are responding to complaints that could have been so easily avoided. Offering advocacy to everyone who has a continuing healthcare assessment is a simple, cost-effective solution,” said Lauren Stoner, Director of External Engagement, VoiceAbility.

Every year, VoiceAbility’s independent advocates:

  • support over a thousand people to make complaints about their healthcare
  • empower more than six thousand people to be meaningfully involved in their care and support planning

Proportionately, we support people to make complaints about continuing healthcare ten times more frequently than supporting them to be involved in care and support planning. This shows just how unbalanced the system is and that urgent action is needed. 

The PHSO recently consulted on a new Complaints Standards Framework. This will ensure that NHS providers and CCGs work to the same standards of complaints handling and response, delivering a more equitable experience for people who make complaints, including about continuing healthcare. VoiceAbility welcomes this framework because it will mean advocates can support people more easily to navigate sometimes complex and opaque processes. 

However, a framework can only do so much. Complaints must lead to action and to systemic change where needed, so that lessons are genuinely learned. There must be an open culture where complaints are welcomed and recognised as an opportunity for improvement.