The Department of Health is resisting reforms required to implement the fairer system of social care funding demanded by the Dilnot commission, one of the commission’s architects has claimed.
Lord Warner, one of the three members of the Dilnot commission into care funding, said officials were against reforms to create a “more credible, objective and transparent” national system to replace Fair Access to Care Services and Continuing Care rules.
Both FACS, which provides eligibility criteria for receiving social care, and the National Framework for Continuing Care, which concerns covers funding for long-term health needs, have been criticised for leading to postcode lotteries for services.
“We’ve been clear in the report that we think there needs to be a major overhaul of FACS and Continuing Care processes. It wasn’t enthusiastically welcomed in the Department of Health civil service cadre,” Lord Warner said at the NHS Confederation conference.
Later, speaking to HSJ, he said: “If we are going to implement our report we will need to standardise FACS on a national basis. We need criteria that are nationally credible.
“There are a large number of variations in terms of people’s experiences in the NHS about Continuing Care. People don’t understand why they have been turned down [for care] when people a few streets away get different services.
“The DH civil servants aren’t keen to do it. But, at the end of the day, what matters is whether ministers are prepared to grasp the nettle. It will be hard to make our recommendations work without FACS and Continuing Care [reform].”
Lord Warner also called on acute trusts to close geriatric wards and fund older people’s care in far cheaper nursing homes. Such a move would integrate care in order to improve older people’s quality of life and boost integration between different elements of the local NHS and social services, he insisted.
“If acute hospitals are going go be more involved in this integration, they have to be prepared to change their business plan – they need to shut down expensive wards and be prepared to buy beds in a nursing home,” he said.
“There’s nothing to stop a foundation trust from paying for nursing home beds which have a degree of medical supervision, rather than funding them in acute wards.”
Responding to Lord Warner’s comments on the commission’s recommendations, a DH spokesperson said: “We remain committed to reforming the social care system.”