Headlines: April 17th, 2003

Doctors are calling for a set of guidelines to ensure that patients are not moved out of hospital beds into a form of Continuing NHS Care (CNC), which fails to meet their medical needs. The BMA sets out the demand in a report which urges the Department of Health to emphasise the needs of the patient.The BMA says patients who could benefit from continuing care are those who do not need to stay in an acute hospital but need nursing, paramedical and medical care that prevents them from being formally discharged.

In a paper calling on the Departments of Health to spell out the importance of the needs of patients to those commissioning care, the BMA states, “Commissioning organisations must ensure that no patient is placed in a bed for CNC where the services around that bed are insufficient to allow the continued provision of safe and appropriate care to the patient.”

The BMA wants guidelines for those wishing to commission CNC to be drawn up in consultation with the Association’s Committee on Community Care. It raises a number of concerns, including a lack of clarity about CNC and who is responsible for providing it and the inadequate provision for patients both in terms of support services like physiotherapy and appropriate medical cover in and out of hours. It is also particularly concerned about access to specialist medical support when it is needed.

Continuing Care can be provided in a range of places including the patient’s own home, a community hospital, or nursing or residential homes. The BMA says it is too often assumed that local GPs will pick up the work involved over and above their normal duties. It says doctors may not have the resources, time or skills to do this and the paper adds, “The costs of this medical care cannot be catered for within current primary care/general practice financial resources.”

Any CNC scheme, it says, must have adequate capital and revenue funding and must not be seen as cheap ‘re-bedding’ or as a way of getting older patients out of acute hospital beds, regardless of the effect on their health.