South Reading Lowest in the Country for NHS Continuing Health Care

The consumer organisation "Which?" has reported that South Reading CCG had by far the lowest rate of provision of NHS Continuing Health Care in the country with the rest of Berkshire West also in the lowest four in England.

The rates per 50,000 population for Berkshire West CCGs (now merged to one) were:

  1. South Reading: 8.28
  2. North and West Reading: 18.45
  3. Wokingham: 18.78
  4. Newbury and District: 19.33

By contrast the top rates per 50,000 population in England were 220.38 for Salford, 146.49 for Thurrock and 141.19 for Wolverhampton.

What is NHS Continuing Health Care? It is social care for adults who are assessed to have a "primary health need" and is paid for by the NHS. It is also possible for a package of care to be funded jointly with the local authority.

The assessment for NHS Continuing Health Care is made by two clinicians involved in the subject's care and looks at the categories of:

  • behaviour
  • cognition (understanding)
  • communication
  • psychological/emotional needs
  • mobility
  • nutrition (food and drink)
  • continence
  • skin (including wounds and ulcers)
  • breathing
  • symptom control through drug therapies and medication
  • altered states of consciousness
  • other significant needs

Eligibility for NHS Continuing Health Care depends on one area of "priority need" or two areas of "severe need". On refusal there is a right to ask for an independent review by NHS England. There is also a fast track process where health is deteriorating fast.

Berkshire West CCG has commented that the elderly population in Reading is unusually low at 12% against a national average of 17.7% (but this is not true of e.g. Wokingham). It is also true that the funding per head of registered population in South Reading is among the lowest in the country. But none of this comes near to explaining the difference in provision of NHS Continuing Health Care with other parts of England. The funding level per registered person is determined by a complex calculation involving the distribution of ages and levels of deprivation in the registered population. The present government changed the formula to increase the weight given to age. Of course, South Reading has a reasonably large student population, but also has areas of unusual deprivation. The life expectancy at birth for electoral wards in Reading spans 11.1 years for males, 7.5 years for females, with the lowest life expectancies in Whitley (males) and Norcot (females). Where life expectancy is low, more of the population will never reach the age for which additional funding is provided, although their need in the late years of their life could be as great as any. Indeed where life expectancy is low, it is generally the case that healthy life expectancy is even lower.

Of course, the low level of NHS Continuing Health Care in Reading will place additional pressure on the already strained budget for adult social care. We have an outstanding local hospital in the shape of the Royal Berkshire Hospital but we probably do not have outstanding provision of adult social care. Perhaps it is time for the NHS to make its full contribution.