In a troubling exposé, letters to The Guardian have shed light on the failings of the NHS continuing healthcare (CHC) system, which is leaving countless sick and elderly Britons without the care they desperately need. Families are finding themselves trapped in a bureaucratic nightmare as they fight for funding to cover essential care for their loved ones.
A System Designed to Fail
Many who have navigated the CHC process suspect that the system is intentionally designed to deny funding to as many people as possible. Despite meeting the strict eligibility criteria of having a primary health need, countless individuals are being deemed ineligible for this vital NHS support.
CHC eligibility numbers per population size have decreased between 2017-18 and 2023-24, despite evidence of greater proportions of people living with complex needs.
– Anonymous health and social care professional
Rather than expanding to meet the growing demand, access to CHC funding has only become more restricted in recent years. The assessment and decision-making process is skewed towards gatekeeping spending above all else, with the NHS and local authorities battling to protect their budgets at the expense of those in need.
Kafkaesque Assessments
Families describe a Kafkaesque system where their loved ones are put through meaningless assessments, only to be met with inevitable rejection. The focus immediately turns to the individual’s finances, not their health needs, as though their personal savings should determine their worthiness of care.
From that moment on, in every meeting about CHC funding, where I spoke for him as he does not have the capacity to do so himself, it was clear that the money was the most important thing about him.
– Janet Maitland, fighting for her relative’s care
Even those who manage to secure funding often do so only after their loved one has passed away, a final insult that lays bare just how cruel and callous this system has become. It’s an exhausting and demoralizing battle that few have the energy to keep fighting.
Costs Over Care
At the heart of this broken system is an endless squabble over who picks up the bill. Local authorities and NHS Clinical Commissioning Groups waste untold public money arguing over funding disputes, money that could be spent actually providing care. It’s a farcical display of bureaucratic dysfunction.
- Countless assessments to determine who pays, not what care is needed
- Vulnerable people used as pawns in a battle between the NHS and councils
- Money wasted on funding disputes that could cover actual care costs
As the population ages and more people find themselves needing complex long-term care, these issues will only intensify. The current approach of rationing and gatekeeping is unsustainable and inhumane. Tinkering around the edges is not enough—we need total reform.
A More Compassionate Way Forward
It’s time to build a social care system that puts people first. Proper integration between health and social care, with a single assessment process and pooled budgets, could eliminate the senseless funding battles. A focus on proactive, preventative care in the community could help people maintain their independence and avoid costly hospital stays.
I hope one day that we will have a properly funded and joined-up health and social care system that so many of us have been advocating for for so long.
– Anonymous health and social care professional
Most importantly, we need a social care system guided by compassion, not cost-cutting. Our approach to continuing healthcare is a reflection of how we value the lives of the sick, disabled and elderly in our society. These are our parents and grandparents, those who cared for us, and how we treat them at their most vulnerable matters deeply.
The COVID-19 crisis starkly highlighted the desperate need for change within social care. As a nation, we clapped for our carers each week in appreciation of their vital work. But appreciation alone is hollow without meaningful systemic change and proper funding. Let this be a clarion call to build a system that cares for people as people, not numbers in a budget.
In one of the wealthiest nations in the world, it is both an economic and moral failing that so many are denied the care they need. As more of us confront the realities of navigating care for our loved ones, the public outcry will only grow. How we rise to this challenge will be the true test of what kind of society we wish to be—one that protects the vulnerable or abandons them.
