Former CHC Lead Admits Truth About How Care Package Decisions Are Really Made In Off Colour 'Joke'.

You may struggle to believe this. Nicki and I, whilst working at a law firm, went to a conference in Manchester - the majority of the delegates were from the NHS, nursing staff mostly, and we met some wonderful, dedicated, people there. It was a fairly small affair having possibly 50-100 delegates.


The keynote speaker was Paul Taylor, who at the time was the lead of strategic development in Continuing Healthcare for NHS England. I have to say, I have never come across anyone whose judgment is so impeded or views so abhorrent when it came to care services. He was talking about his time as a Commissioner of care services for a CCG – a role that requires signing off on care packages for the elderly and vulnerable - and said;

“Nurses would come to me at my desk after assessments and be recommending a care package requiring 4 visits a day [to the vulnerable person’s home] – I’d just look at them and they knew they had to come back with an assessment that required 2 visits – or less.”

After him laughing, the room was largely silent. I was stunned that he had actually admitted this in a public forum – albeit he thought all attending were NHS staff – that the needs of vulnerable people struggling to stay in their own homes were (A) second to the legal duty to commission appropriate care packages, and (B) could be easily disregarded without even knowing the facts giving rise to the needs of the poor NHS users whose Commissioning he was responsible for.


As soon as he had said it – the loathing from all the hard-working NHS nurses was almost palpable. No one so much as chuckled as this man basically admitted to the nursing staff present that their hard work in assessing needs was second to financial considerations – I’m not convinced that anyone quite knew what to say. I shuffled close to Nik and whispered “Did he just say what I think he just said?” (or words to that effect – there may have been an expletive in there somewhere). Nik was processing her own disbelief. I stuck my hand up and said:


“As a Lawyer and journalist who writes a lot on the topic of Continuing Healthcare Funding – I find your comments very interesting – Is it not supposed to be about need as opposed to money – legally? There are desperate families on the end of these decisions that you’re talking about.”


He went grey, jangled some change in his pocket, and looked incredibly uneasy. Of course, he tried to laugh it off after recovering and declined to expand on the theme he’d embarked on. The conference moved on to the next break for coffee, during which the organisers of the conference came and found me and explained that Mr. Taylor was not told that there were any lawyers or journalists in the room and wanted to know what I was going to write. At the time I was doing very little writing and was a Director and Head of Civil Litigation at a firm of solicitors, so it was very difficult to write the truth in the forums that I had available without a risk of the firm being sued.


If you want to know why this is important, a look at Mr.Taylor’s Linkedin account explains:

'I worked for 2 years as part of the NHS England, Continuing Healthcare Strategic Improvement Program. I was responsible for the creation of the CHC Delivery Model which is the NHS England and ADASS guidance on how CCGs and STPs should operationally deliver CHC. It is the national understanding of the CHC National Framework, revised 2018.'


Mr Taylor then went on to explain that it was his view that assessments for eligibility for Continuing Healthcare funding could be undertaken by a computer algorithm.


All we would say to Mr Taylor is that his attitude has no place in meeting the needs of the vulnerable, the dependent, or the elderly. As a default setting both Nicki and I are by nature optimistic – I have tried to see some positives from the whole interaction and there is one. When he made his comment about denying funding in the face of assessed need, not a single giggle – not a single conspiratorial chuckle - came from the nursing contingent which made up 95% of the audience. There was nothing but stunned silence, leaving Mr Taylor guffawing alone. The Nurses present were not impressed and made it clear by their silence - the perfect response.


If Mr Paul Taylor – who at the time of writing and according to his Linkedin page now works as a CHC Transformation Consultant to ‘Liaison Group’ – should want a right of reply, we are happy to publish any response offered. In the same spirit, if any CHC Nurse Assessors, District Nurses, or others, involved in the business of assessment of needs for the vulnerable and weak who have experienced Mr Taylor’s ‘look’ in response to presenting care packages to him – we’d love to hear from you.


If we have misreported any comments we would be happy to accept service of defamation papers at our office, but it is our firm belief that this attitude has no place in this industry.

The following conference organised by the same event staff was far better – the speakers were a Lawyer and a Nurse from Kettering, talking about the implementation of the 2018 National Framework.


Thanks for reading – Adam.