National Eligibility Criteria – A Fairer System, or Institutionalised Unfairness?


The government recently published draft guidelines for determining who qualifies for council-funded home care. These guidelines are subject to consultation with the new regulations coming into force next April.

So, if you have a view you have until August 15 to make it known.

What’s the issue?

The government is attempting to have uniform qualification criteria right across the country. Currently local authorities can classify needs as low, moderate, substantial or critical. Out of 152 councils, 19 currently fund care at low or moderate levels while the majority fund care when it is evaluated at the ‘substantial’ level.

And let’s be clear about this, councils are not excluding the lower levels of care because they think they are unnecessary, it’s purely a financial decision.

It’s feared that people currently receiving care at low or moderate levels will lose funding under the new system as the threshold will be similar to the current ‘substantial’ level.

Organisations such as Age UK and the Alzheimer’s Society are also questioning whether this is the appropriate level to draw the line, and what knock-on effect this will have over time.

Caroline Abrahams, charity director at Age UK commented that: “The regulations are written in such a way that we worry that people with dementia who need help to continue to live at home with dignity could be screened out, together with those who struggle with dressing, or washing, or going to the toilet or preparing food.

“From now on the inability to do just one of these fundamental things will not be enough to qualify you for support and Age UK’s concern is that without it, some older people’s needs will escalate, undermining their capacity to continue to live at home.”

A missed opportunity?

Rather than institutionalising a highly rationed care system, there was an opportunity to evaluate and recognise the role of effective home care services in a bigger health and social care picture.

If we make it harder for an ageing population to live in their own homes with dignity and professional support, what knock-on effect does this have on residential care, community healthcare and A&E?

And has there been an evaluation of the potential wider benefits in the authorities that currently fund lower levels of support? Does more flexible home care provision have the potential to be part of a preventative and ultimately more cost-effective health care system?

National eligibility criteria could be a good thing or could be highly detrimental – it’s a question of where you draw the line.

domiciliary care management


Dan Farrell-Wright


Domiciliary care management software, ISO 27001 accredited.

Photo Credit: Gerard Arcos via Compfight cc

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