Yvonne Goodwin: Care sector hiding an elephant in the room

By Yvonne Goodwin

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Nov 09, 2018
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In September, I wrote about addressing the elephant in the room that is the fact elderly clients’ financial plans can get derailed through ill health. My request was based on recent personal experience of the NHS and its associated frustrations.

Well, this month I have managed to find an even bigger elephant in the room (you might say woolly mammoth) that no one in the NHS or local authority wants you to know about.

Advisers armed with the information will be able to deliver significant value to clients during difficult times.

With all the people involved in my mother’s care, it became apparent she was unable to go back to independent living within her sheltered housing complex.

At a meeting with the rapid response team social worker, it was agreed that she would need residential care.

My sister and I were given the unenviable task of finding a suitable care home for her.

The nurse present at this meeting mentioned something which the social worker quickly brushed away as not required.

Perhaps I have been around in financial services for too long, but it stuck in my mind to the point I went away and did some research. It was called NHS continuing healthcare.

In essence, everybody leaving NHS care, whether that be hospital, recovery hub or so on, has a right to be assessed for ongoing care arranged and funded by it. There is an initial checklist assessment that can be completed by a nurse, doctor, other healthcare professional or social worker.

If eligible, the patient will be referred for a further, full evaluation.

I quote from the national framework for NHS continuing healthcare, as updated with effect from 1 October: “Primary health need is a concept developed by the secretary of state for health to assist in deciding when an individual’s primary need is for healthcare (which it is appropriate for the NHS to provide under the 2006 Act), rather than social care (which the local authority may provide under the Care Act 2014).

“To determine whether an individual has a primary health need, there is an assessment process, which is detailed in this national framework.

“Where an individual has a primary health need and is therefore eligible for NHS continuing healthcare, the NHS is responsible for providing for all of that individual’s assessed health and associated social care needs, including accommodation, if that is part of the overall need.”

Up until this rapid response team meeting, no one had addressed this. Bearing in mind my mother had been hospitalised on 4 July and this meeting took place in mid-September, you would have thought there had been ample time.

A confession here too: I sat the long-term care exam in 2010, which covered this issue. Did I remember it? No.

All advisers should familiarise themselves with this. It could prove invaluable help to clients in this position themselves or who have parents in such situations.

You can find out more about this topic by visiting england.nhs.uk/healthcare

Yvonne Goodwin is managing director of Yvonne Goodwin Wealth Management

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