Problems with discharge into a care home
You may be happy with the idea of moving into a care home, particularly if you have worries about how you would manage at home. However, it is important to note that you cannot be discharged into a care home against your will. This could be because you think you could manage at home – if this is how you feel then you need to talk to the person who carried out your assessment for community care services. This is because your wishes should always be taken into account during an assessment; maybe other services could be offered that would help you cope at home.
However, it may be that you don't wish to be discharged into a care home as you feel you still need the sort of care that can only be provided by the NHS. As explained earlier there is national eligibility criteria for continuing NHS health care. The NHS board in Scotland and local health board in Wales has its own rules (or ‘eligibility criteria’) for working out whether you are entitled to carry on getting care under the NHS. But if you have not been assessed as needing this sort of continuing care, then you don't have the right to stay put in a hospital bed indefinitely.
The social services department of your local council has a responsibility to work with hospital and community-based staff, and with you and your family, to try to find another acceptable way of meeting your needs. But, if you can't reach an agreement, then the hospital can discharge you to your home. Care services must be arranged for you at home before you can be discharged in this way. However, these services might not cover all of your needs as government guidance says that such services only have to be provided ‘within the options and resources available’. You may also have to pay for the care services provided by the social services department.
Being discharged in this way can be distressing for everyone involved. So, as a final check before you are discharged, you (or your family or carer) have the right to ask for a review. This review will look at the decision that has been made about your entitlement to continuing NHS in-patient care. Usually, the Strategic Health Authority will seek advice from an independent panel. This panel will have an independent chairman, and will include a representative of the Strategic Health Authority and your local council.
The panel has to consider whether the rules for deciding whether you need continuing NHS care have been correctly applied. It is not able to look at whether the rules themselves are fair. Members of the panel will speak to you and your family, and may also get advice from hospital staff.
The panel can also ask for independent clinical advice on your condition if it thinks this would help. The panel's recommendation does not have legal force, but it is expected that the Strategic Health Authority will usually accept the panel’s view.
If you feel that you should be entitled to NHS-funded continuing care you can ask your primary care trust to review your care needs again. Get more advice on this issue from SeniorLine on 0808 800 6565 (0808 808 7575 if you are in Northern Ireland).
