Clinical commissioning groups have warned they are at risk of being “saddled with an inherited debt” when they take on their new powers, as a result of an onslaught of retrospective claims for NHS continuing healthcare funding.
The warning – from representative group NHS Clinical Commissioners – came as the Department of Health confirmed primary care trusts had so far received around 60,000 backdated requests for continuing care funding in 2012-13.
The surge in requests this year came after the department set a final deadline of 30 September 2012 for anyone wishing to claim back the costs of care received between 2004-05 and 2010-11.
An HSJ analysis of the latest published finance reports of around half of England’s 151 PCTs suggests that PCTs across the country will have to set aside hundreds of millions of pounds this year to settle the claims (see briefing).
However, commissioning groups are concerned the volume of claims will mean PCTs will not be able to accurately assess the full scale of their liabilities before they are abolished in April.
PCTs need to persuade their auditors that they have made an accurate assessment of these liabilities in order to make provision for them in their accounts. If a PCT cannot do this, the expected costs will be set down as “contingent liabilities”, and the PCT will not be able to set aside money from this year to enable its successor CCGs to pay the claims.
Julie Wood, commissioning development director for NHS Clinical Commissioners, told HSJ that CCGs risked “being saddled with an inherited debt the scale of which they are not able to quantify and with no additional resource”.
She added: “CCGs must not be hamstrung by a contingent liability which is imposed on them just as they are to start delivering for their patients and populations.
“We expect the Department of Health and the [NHS] Commissioning Board to send a strong message to PCTs that they are required to do all they can to assess the liability for continuing healthcare and make provision for this within their 2012-13 accounts.”
It is likely to prove particularly controversial if CCGs are saddled with these costs, as the department has previously assured groups they will “not be responsible for resolving PCT legacy debt that arose prior to 2011-12”.
One CCG chief officer told HSJ they wanted to see a “national solution” to the problem – probably some money set aside nationally to cover contingent liabilities for retrospective claims. A commissioning board spokesman told HSJ that the Department of Health was “currently working to find a solution” to cases where PCTs were unable to make provision for all backdated claims.
A DH spokeswoman said it was “looking at the financial management implications and what happens after the transition to CCGs”. However, she revealed that just a month from the end of the financial year this work was still “on-going” and “no decisions have been made yet”.