Week commencing 31st August is anticipated to hand down its ruling on who should be responsible for the shortfall in funding nursing contribution (FNC). The University Health Boards (UHBs) are fighting the local authorities (Las) to decide who should fund the shortfall.
So how has this shortfall arisen and why is there a dispute over who should fund it? The story starts a number of years ago when under a threat of a judicial review the health boards across Wales agreed to show that the level of FNC was reasonable. To achieve this a procurement panel was established and I was seconded onto that panel to represent the independent care home sector.
We decided to appoint Laing and Buisson to undertake this review and a format was agreed on how the nurses time was spent. Direct involvement with patients including care planning, time spent on non-specialist nursing tasks such as feeding or indeed just on standby.
The reason for this was that the health boards did not want to fund social care time nor stand by time. They also wanted to understand whether the nurse was looking after continuing healthcare (CHC) patients or FNC patients.
As a result of all this, a sum was established by reference to nurses pay rates and hours spent by nurses per FNC patient for just what was considered nursing tasks. Also identified was the cost of stand by and the better understanding of CHC costs. (This was about £42 more than FNC if I recall correctly).
The outcome of all this was that UHBs tried to compromise the findings and a judicial review ensued that found that the results should be rewarded to providers. With guidance from Welsh government totally lacking the ‘social care’ element was then disputed by the UHBs and Las with providers taking no part.
This supreme court hearing was conducted earlier in 2017 and the outcome of the hearing should be conclusive. Hopefully, there will be no further appeals. The providers should then be entitled to be rewarded for the services they have been giving not only currently but hopefully since the review was initiated.
