How the ‘continuing healthcare’ system is failing sick and elderly people

‘The biggest farce is the amount of public money spent by local authorities and ICSs arguing about who should pay for someone’s care when their eligibility is disputed.’ Photograph: Peter Titmuss/Alamy

I empathise with Dr Michael Duxbury (Letters, 29 December), but no amount of empathy will increase the chances of his mother, or anyone else’s loved ones, becoming eligible for continuing healthcare (CHC). Excuse the flippant tone, but having worked in the health and social care sector for more than a decade, I had always hoped that a proper integration of health (NHS responsibility) and social care (local authority responsibility) would eradicate this ridiculous framework.

CHC is a funding stream administered by local integrated care systems (ICSs), whereby people who have a primary need for healthcare (not social care) will have their entire package of care paid for by the NHS. Unlike social care, there is no assessed charge to the person for this care. CHC eligibility is subject to assessment and decision-makers consider four key components of the person’s needs: nature, intensity, complexity and unpredictability. In practice, I have found that decision-making is undoubtedly influenced by an overarching need to gatekeep spending.