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24.10.14

High eligibility thresholds for Care Act ‘short sighted’

The government is to introduce a national minimum threshold that adults will have to meet in order to receive social care support from April 2015 as part of the Care Act, replacing the current council eligibility assessments that judge people’s needs as critical, substantial, moderate or low. 

As demand has soared while budgets have shrunk, more and more councils restricted care provision to only those with ‘substantial’ or sometimes even only ‘critical’ need. 

In its final regulations guidance, the Department of Health (DH) has amended the regulations, so it is now clear that a person is eligible for care and support if their wellbeing is significantly impacted by their inability to achieve two or more outcomes, out of a list of 10. 

The Act will introduce a national minimum threshold for social care for the first time rather than eligibility being set locally by councils. Most local authorities currently restrict care to people with at least ‘substantial’ needs, and often only ‘critical’ needs, although application of the threshold varies locally. 

By introducing this threshold, many campaigners argue that the government has missed an opportunity to broaden the entitlement to support, and will leave many older and disabled people worse off. 

The Care and Support Alliance stated that research by London School of Economics shows that 340,000 people – who struggle to live on their own but still fall below existing council eligibility thresholds – will continue be locked out of the care system. 

Richard Hawkes, chair of the Care and Support Alliance, said: “The Care Act is a ground-breaking piece of legislation – capping catastrophic care costs and ending the postcode lottery. But it will only live up to its promise of a genuinely preventative system that promotes wellbeing, if the government re-thinks its plans to exclude so many older and disabled people from the system. 

“Setting a high threshold for the care system is a bit like going to the doctor with a chest infection and being told to come back with pneumonia.” 

Jeremy Hughes, chief executive of Alzheimer’s Society, stated that by setting the eligibility criteria for council-funded social care so high, thousands of people with dementia will be cut off from the vital support they need and deserve. “It is absurd logic that services that help prevent people from reaching crisis point are given such low priority,” he said. 

Janet Morrison, chief executive of Independent Age, argued that the threshold is short sighted because many of those outside the care systems may, as a result, need to draw on health and other services earlier as a result. 

ADASS president David Pearson welcomed the publication of the Care Act guidance and regulations which will drive how care is arranged in practice from April next year and affecting many millions of users and carers in this country. 

The DH stated that consultation respondents were widely in favour of having a national threshold, saying the proposed regulations were comprehensive and easy to understand by comparison to the existing approach. 

A spokesperson at the DH said: “Helping people to live independently and prevent them from becoming ill is what people want and is a better use of our resources. 

“The Care Act and our £3.8bn Better Care Fund will focus on keeping people well, which can save money and prevent people needing more support. We are clear that people, whatever their level of need, will receive help from their council to get support and information.” 

Tell us what you think – have your say below or email opinion@nationalhealthexecutive.com 

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