A shock report into the devastating impact of public service failures on individuals has revealed a south Lincolnshire patient overpaid more than £102,000 in nursing home costs.
The report by the Parliamentary and Health Service Ombudsman includes a snapshot 192 case summaries of 1,075 investigations of unresolved complaints.
In the report, Ms R complained that the South Lincolnshire Clinical Commissioning Group (CCG) had failed to meet the full cost of her father’s nursing home care, although he was eligible for NHS continuing care funding.
NHS continuing healthcare is a package of free care arranged and funded solely by the NHS for individuals who are not in hospital and have been assessed as having a “primary health need”.
Ms R’s father, identified as Mr V in the report, was living in a nursing home in south Lincolnshire and was found eligible for NHS continuing care funding from spring 2013. As Mr V had moved to another region, the CCG where he had previously lived only became aware in autumn 2013 that it was responsible for meeting his costs.
During the period spring to autumn 2013, Mr V paid for the cost of the nursing home and Ms R submitted the invoices to the CCG. The CCG said it had agreed with the nursing home that Mr V’s care costs were £800 a week and only refunded the invoices up to this amount. After refunding this money, the CCG then started to pay the nursing home £800 a week for Mr V’s ongoing care. However, the actual fees the nursing home charged were £1,680 a week and Ms R was invoiced for the outstanding costs which were not covered by the CCG’s payments.
The report said the CCG had unnecessarily delayed sorting this out and had failed to give Mr V an appropriate refund.
This week a spokesman for the South Lincolnshire Clinical Commissioning Group said: “We are unable to comment on the details of individual cases. Nevertheless, in this case I can confirm that we have apologised to the patient and their family and reimbursed the additional fees paid to the nursing home. We continue to fund high quality nursing care.”