Chamber and committees

NHS continuing healthcare has never been subject to a specific funding stream, and no funding has ceased as a consequence of our publication of new guidance. Scotland and England have always had different eligibility for NHS continuing healthcare. We simplified the system in Scotland with the guidance on Hospital Based Complex Clinical Care. Patients receiving support under English NHS continuing healthcare eligibility, and for whom the host authority agrees a move to Scotland, will have their care costs met by the NHS in England.

NHS continuing healthcare has never been subject to a specific funding stream, and no funding has ceased as a consequence of our publication of new guidance. Delayed discharge patients are awaiting discharge from the NHS. If a patient was eligible for NHS continuing healthcare guidance, or is eligible for Hospital Based Complex Clinical Care, then they are by definition not ready for discharge, and are not delayed.

NHS continuing healthcare has never been subject to a specific funding stream, and no funding has ceased as a consequence of our publication of new guidance. At the latest census (March 2015) there were 1,545 people in receipt of NHS continuing healthcare. 1,187 were in hospital and are unaffected by the publication of the revised guidance. The cost for the remaining 358 will continue to be borne by the NHS as long as they remain eligible under CEL 6 2008 criteria. There will be no cost for these individuals' care to the local authority or the individual. The estimated cost to the NHS will be around £11.17 million per year.

Over the next three years the Scottish Government will invest £50 million, as part of the Primary Care Fund, to address immediate workload and recruitments issues in primary care and put in place long-term, sustainable change to support GPs and improve access to services for patients.

As part of this, £2.5 million will be invested in work to explore with key stakeholders the issues surrounding GP recruitment and retention which can be particularly challenging in certain areas of the country. Additionally, the Scottish Government will continue its support for NHS Education for Scotland's Enhanced Returners Programme that was introduced in 2015-16.

The number of GPs working in Scotland has already increased under this administration’s term in office and the First Minister announced on 27 October 2015 that the number of training places for GPs will increase from 300 to 400 a year from next year, contributing towards a more sustainable future GP workforce by 2019.

NHS continuing healthcare has never been subject to a specific funding stream, and no funding has ceased as a consequence of our publication of new guidance. Patients did not "apply" for funding or support under previous arrangements – their needs were assessed according to guidance that has now been revised, and which applies to packages of care provided and solely funded by the NHS. Anyone assessed as eligible for NHS continuing healthcare under CEL 6 (2008), i.e. the criteria applied prior to 1 June 2015 will continue to receive this as long as they remain eligible as per CEL 6 (2008).

The independent review panel discussed NHS continuing healthcare with a range of stakeholders. The Scottish Government then discussed the recommendations and revised guidance with stakeholder representation, and held two engagement events in conjunction with the Health and Social Care Alliance.

The GP retainer scheme is an initiative which is run by health boards and National Education Scotland, as such it is not a government run programme, however the improved GP retainer scheme will have greater educational input and direction than was possible under the previous arrangements.

NHS continuing healthcare has never been subject to a specific funding stream. Rather, healthcare is provided by NHS boards from their overall funding allocation as provided by the Scottish Government. Information on how many people received NHS continuing healthcare in the community is available on the Information Services Division website: http://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/NHS-Continuing-Care/. Data collection started in 2008.

England and Scotland have applied different systems for a number of years regarding NHS continuing healthcare and free personal care. The Scottish Government is not monitoring cross border movement in terms of NHS continuing healthcare neither is it monitoring movement to Scotland in order to take advantage of free personal care.

Anyone eligible for NHS continuing healthcare prior to June 2015 will continue to receive this in any setting, as long as they remain eligible under the previous eligibility criteria contained in CEL 6 (2008). This is made clear in our new guidance DL (2015) 11 – Hospital Based Complex Clinical Care.

Guidance on Hospital Based Complex Clinical Care issued in May 2015 and makes it clear that people should only receive care in a hospital if they cannot be cared for in a more appropriate place. This will require health and social care teams to work in an integrated way to provide more care in homely settings. Care home providers are working with us – as well as our partners in local government and the health service – to design cost-effective and flexible models of specialist residential care. This is in line with our 2020 vision to ensure that people are supported to be independent and remain at home, or in a homely setting, for as long as possible.

One type of care currently being developed is the Intermediate Care model of ‘step-up / step-down’ beds that support people to be cared for closer to home in a range of settings, including community hospitals and care homes. This was also a recommendation of the residential care task force and one that we will continue to work with partnerships to develop further.

Guidance on Hospital Based Complex Clinical Care issued in May 2015 and makes it clear that people should only receive care in a hospital if they cannot be cared for in a more appropriate place. This will require health and social care teams to work in an integrated way to provide more care in homely settings. Care home providers are working with us – as well as our partners in local government and the health service – to design cost-effective and flexible models of specialist residential care.

The Scottish Government is committed to ensuring that compassionate, high quality palliative and end of life care is provided for anyone who requires it. We are now working with all stakeholders across health and social care to develop a Palliative and End of Life Care Strategic Framework for Action. This will provide an additional focus and support the delivery of high quality palliative and end of life care, including in a residential care setting. This framework will be published towards the end of 2015.