Exclusive: NHS chiefs set to face £100m bill for care fees error

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NHS chiefs face bills of up to £100m to cover the cost of healthcare fees wrongly paid by thousands of families in Yorkshire.

Officials are sifting through nearly 6,000 applications to reclaim NHS continuing healthcare costs dating back as far as 2004.

Some families could be in line for six-figure awards after mistakenly being forced to pay care fees for sick relatives which should have been picked up by the NHS.

The Yorkshire Post calculates the bill could exceed £80m, based on current NHS predictions in the region, with significant costs of assessing each claim adding a further £10m – amid warnings the huge numbers could take years to sort out.

But health bosses are warning uncertainty over the huge scale of the payouts could have a damaging impact on new GP-led clinical commissioning groups (CCGs).

Worst affected areas are likely to be those already facing financial problems, among them North Yorkshire where as many as 1,000 claims have been received.

But even in parts where cash has been set aside to fund claims, the payouts will deprive health chiefs of cash to deliver key initiatives.

NHS continuing healthcare is free where sick individuals primarily have long-term health needs including funding of care home fees. But failures to carry out effective assessments have prompted a retrospective review of cases.

Nine of the region’s former primary care trusts, accounting for just over half of nearly 6,000 claims, estimate they face bills of £47m to cover the costs, equivalent to £84m across Yorkshire.

Some estimates put the total cost in England at £1bn, triggering calls for national action.

Lisa Morgan, partner at law firm Hugh James representing 6,000 people claiming they have wrongly paid fees, said she understood there were more than 60,000 outstanding cases across the country, putting “additional strain” on already-stretched CCGs.

“Families have had to sell homes to pay for care, which should have been paid by the NHS. It is important that this wrong is put right as soon as possible,” she said.

“I believe far more resources need to be put in place and for England to take a leaf out of Wales’s book by handling the outstanding cases from a central location, rather than each CCG taking their own caseload.”

A spokesman for NHS Clinical Commissioners, representing CCGs, said there was a mixed picture across the country, but added: “A number of areas still do not have certainty over what their liabilities are likely to be. It’s very serious because they need to ensure they meet their responsibilities for continuing care but at the same time they want to do a lot of work in their areas and they can’t if they are unable to fully plan ahead.”

In a statement, the four CCGs covering North Yorkshire except Craven said the full costs had yet to be calculated. Some money had been set aside but “any costs over and above the provision will fall to the CCGs to fund”.

Officials in North Lincolnshire said the costs would not have a direct impact on existing services. But they added: “It does mean that the non-recurrent funds available for other purposes will be reduced. Those funds are used for example to pump-prime service change.”

The Department of Health said: “We are working with NHS England to handle the assessment process for eligibility for NHS continuing healthcare. This includes looking at financial implications for CCGs.”