NHS Continuing Healthcare

Debate between Stephen Kinnock and Iqbal Mohamed

Wednesday 25th March 2026 Westminster Hall

[Iqbal Mohamed]

It is the responsibility of ICBs to administer and provide this support, but does the Minister share my concern and that of my hon. Friend the Member for Birmingham Perry Barr (Ayoub Khan) that the involvement of private contractors in eligibility reviews may not be appropriate? The ICB may feel that responsibility lies with the private contractor to guide it, rather than owning its decisions.

[Stephen Kinnock]

Of course, we want to see consistency and quality right across the board, regardless of who is actually delivering the work. If there are specific issues around private contractors that the hon. Gentleman can flag to me, perhaps he could write to me; we would be very happy to look into them.

We have committed to reduce the running costs of integrated care boards and to redirect that funding to frontline services. To deliver that, our 10-year health plan sets out that integrated care boards must focus on their role as strategic commissioners, ensuring the best possible value in securing local services that improve population health and reduce inequalities. However, NHS England has been clear that, although transformation is required, it must be carried out with clear safeguards in place to protect frontline responsibilities. Legal duties in relation to NHS continuing healthcare must continue to be met. This means that running-cost reductions should aim to make administrative and corporate functions more efficient. They are not there to change funding for direct care or statutory duties.

I acknowledge that integrated care boards have worked intensively to strengthen their plans for 2025-26, focusing on areas where efficiencies and savings can be made. I thank NHS England for working with integrated care boards to monitor spend against these plans. The Department is working closely with NHS England on how responsibilities will be delivered from April 2027 onwards, when—subject to the will of Parliament—NHS England will be abolished. Until those changes are made, the Department and NHS England will continue to carry out their respective statutory functions. In the interim, teams are increasingly working together closely under an interim joint leadership team, including on NHS continuing healthcare.

Fundamentally, addressing some of the issues that hon. Members have discussed today will require wider reform of the social care system. That is why Baroness Casey is chairing an independent commission into adult social care. The commission has a clear mandate to undertake the most comprehensive review of adult social care in a generation. With Baroness Casey as its chair, it will cut through the political stalemate, identify what the country needs and wants from adult social care, and support the Government in establishing a system that works.

Baroness Casey has made it clear that she will not wait until the end of the commission to recommend action where she sees fit to do so. Hon. Members may have seen her speech at the Nuffield Trust summit on 5 March. I thank her for setting out recommendations for immediate action on adult social care, which focused on three key areas: safeguarding, dementia and motor neurone disease. We will not waste time in taking those recommendations forward. We look forward to reviewing Baroness Casey’s phase 1 report, which is due later this year and will set out further recommendations to address immediate priorities for adult social care in this Parliament, laying the groundwork for long-term reform and setting us on the path to delivering a national care service.

In her recent speech, Baroness Casey rightly raised challenges with NHS continuing healthcare. We are carefully considering her reflections. I acknowledge existing tensions between integrated care boards and local authorities regarding NHS continuing healthcare eligibility decisions. Those decisions hinge on whether the support required by an individual is above the limits of what the local authority can provide. Integrated care boards must consult with the relevant local authority before making any decision about an individual’s eligibility for NHS continuing healthcare, putting individuals at the heart of the decision-making process.

However, I acknowledge that, in practice, it is not always straightforward to determine clearly who is responsible for meeting an individual’s needs, so we are working with NHS England to better join up support between the NHS and local authorities, exploring areas where good joint working is helping to improve outcomes for people accessing NHS continuing healthcare. Through the development of our neighbourhood health services, local authorities and integrated care boards are encouraged to consider how services can be reconfigured to focus more on prevention and early intervention, embedding new ways of working to set the direction of travel for future years.

I want all individuals who are eligible for NHS continuing healthcare to receive support in a timely manner, and I want the assessment process to be as smooth, clear and transparent as it possibly can be. We know that eligibility rates can vary from year to year, and across regions and integrated care boards. That variation often exists for good reasons, including differences or changes in the health needs of local populations or individuals over time. To check that the variation is warranted and justified, NHS England continues to monitor eligibility rates by undertaking detailed work to compare eligibility and referral rates between integrated care boards. When it identifies unwarranted variation between integrated care boards with similar demographics, it follows up and seeks to ensure coherence and consistency.

My Department is also engaging with local areas to explore current work on eligibility disputes, and how they address those challenges. There are no quick fixes, but we remain committed to supporting the sector to improve outcomes for individuals. I want to stress that while disputes between organisations are being resolved, individuals must never be left without the appropriate care and support.

There is a robust dispute resolution process in place for when a full assessment for NHS continuing healthcare has been undertaken and the person or people concerned disagree with the outcome. First, an individual or their representative can ask for a local review from the relevant integrated care board. All integrated care boards should have developed a local resolution process that is fair, transparent and includes timescales. Where it has not been possible to resolve the matter locally, an individual may apply to NHS England for an independent review panel to review the decision. Finally, if the original decision is upheld and there is still a challenge, the individual can make a complaint to the Parliamentary and Health Service Ombudsman.

I was very sorry to hear from the hon. Member for Birmingham Perry Barr of the difficulties that his constituents are experiencing, and I thank him for sharing the details of Daniel’s case. I would of course be happy to receive further representations from the hon. Member. Perhaps he could start by setting out in a letter what the issues are, and then we can make sure that appropriate action is taken.

I also know that concerns have been raised about the relatively low number of individuals who are ultimately found eligible for NHS continuing healthcare after they have been referred for full assessment. The threshold for initial referral by GPs, social workers and others is deliberately set low to ensure that anyone who may be eligible is fully assessed. For that reason, many individuals will not go on to receive NHS continuing healthcare. However, an assessment is also a gateway to other forms of NHS-funded support, such as NHS-funded nursing care and joint packages of care between local authorities and integrated care boards. My Department and NHS England continue to work with partners, including the CHC Alliance, Dementia UK, the Nuffield Trust and other sector bodies. We want to support integrated care boards in delivering national policy and guidance, including on how we can achieve better join-up between the NHS and local authorities.

I congratulate the hon. Member for Birmingham Perry Barr again on securing this important debate—and I thank all those who intervened in it—so that we can continue to focus on improving services for the people who need them most. I know that this is a very challenging and emotive topic for many families who are going through extremely difficult times, and I absolutely accept that sometimes controversial decisions are made. We need to ensure that in every one of those controversial cases there is transparency, clarity and coherence. I look forward to working with the hon. Gentleman and with Members across the House to ensure that, collectively, we achieve that goal.

Question put and agreed to.

GP Contract

Debate between Stephen Kinnock and Iqbal Mohamed

Monday 16th March 2026 Commons Chamber

[Stephen Kinnock]

My hon. Friend is right that it is vital that ICBs have a clear understanding of their population health needs and their demographics. It is important that the ICB is ahead of that curve and taking decisions well in advance of a practice closing down so that a commensurate service is provided; that is a really important part of the ICB’s responsibilities. If he has specific examples where he feels that his ICB has not been delivering on that basis, he is welcome to share those with me.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

I pay tribute to the GPs in Dewsbury and Batley and the surrounding villages. The Minister mentioned preventive health. What steps are the Government taking to support GPs in their treatment of patients with preventable or avoidable diseases through the prescription of exercise and healthy foods? Secondly, we talk about online access, which is welcome—my constituents welcome surgeries that offer appointments throughout the day—but how will the Minister support the digitally excluded who cannot get through at 8 am and do not have access to online applications?

[Stephen Kinnock]

On prevention, there are some really important measures in the contract: in essence, we are recalibrating the quality outcomes framework, which is the basis for payments to incentivise the actions that GPs take. By changing the QOF, as it is called, we can shift that in one direction or the other, and we have changed it to incentivise boosting childhood vaccination rates, particularly in those areas of the country where vaccination rates are worryingly low, and better care for patients living with obesity. That is about exactly the things the hon. Member just mentioned: prescribing, if you like, exercise regimes and advising on better nutrition. We are also changing the QOF to require GPs to share data with the lung cancer screening programme. Those are just three examples of what we are doing within the contract.

On online access, it is clear that there must always be three channels of access to a GP—walk-in, telephone and online—and that for an urgent matter it would be a walk-in or a telephone call. What has really worked is that online access has taken pressure off the telephone lines as people who do not have urgent requirements have been migrating online and using the NHS app—take-up of the app is also excellent—so we are moving in the right direction.