Health minister Jacqui Smith has issued draft guidance on how free nursing care will be implemented for elderly people in nursing homes in England.
It proposes three 'bands of weekly nursing care need' - costed at£35,£70 or£110 - to be determined following an assessment of the patient. Health authorities and primary care trusts are to establish teams of nurses to do the assessments, and nominate a registered nurse co-ordinator who will oversee their work and ensure consistency.
Ms Smith announced that HAs would receive a total of£80m in 2001-02 to implement free nursing for those who currently fund their own care, based on an average current cost of£85 a week.
Implementation will follow the definition of nursing care in the 2001 Health and Social Care Act as 'the registered nurse contribution to providing planning and supervising care in a nursing home setting'. Controversially, this does not include any time spent by healthcare assistants.
The proposals will go out for a four-week consultation with feedback used to 'revise and finalise the bands'.
A Department of Health spokesperson denied that the banding system would cap the amount of free nursing care an individual could receive. 'If someone falls above the top band, we will provide care if necessary, ' she said. But she added: 'It will obviously have to be assessed quite heavily as to whether it really is necessary.'
Help the Aged health policy officer Jonathon Ellis said the guidance was 'very complicated, very technical and It is a case of going over it with a fine-tooth comb to look at the implications'.
He was concerned that the complexity and 'legalistic tone' would prove difficult for elderly people and their relatives to make sense of.
'It underlines the fact that It is an over-complicated policy. The alternative would have been to implement the royal commission in full as in Scotland.'
The Scottish Parliament is to fund free nursing and personal care, removing the need to assess separately nursing and personal care needs.
Finalised guidance for England will be published in September.
From 1 October, free nursing care will be implemented for those now paying for their own care and from 1 April 2002 this will be extended to everyone receiving nursing care in a nursing home.