The Health and Social Care (Wales) Act 2025
The 2025 Act Health and Social Care (Wales) Act 2025 received Royal Assent on the 24 March 2025. Its major impact will be to restrict, in Wales, the making of profit in the provision of care home services for children as well as for fostering and secure accommodation services.
This short posting concerns two other measures in the Act. The first concerns the making of direct payments for people who are eligible for NHS Continuing Health Care funding and the second involves putting beyond doubt the point at which a person becomes eligible for such funding.
NHS Continuing Health Care and Direct Payments
For many years we have drawn attention to the failure of the Welsh Government to ensure that Disabled People in Wales of all ages who are eligible for NHS Continuing Health Care and who want to remain living in the community – have the right to a direct payment for their health and social care needs.
With the passing of the Health and Social Care (Wales) Act 2025 there is hope that the right to support of this kind may now be in sight. The Act amends the National Health Service (Wales) Act 2006 by inserting new sections 10B, 10C and 10D which provide for a regulatory scheme to be developed to facilitate the making of such payments. The approval of the necessary regulations, the relevant guidance and the practical arrangements will mean that these measures will not come into force until the first half of 2026, at the earliest.
It has taken far too long for Wales to get to this point and the personal cost to many Disabled People has been great. For an informative article on these reforms published by the Local Government Lawyer click here.
NHS Continuing Health Care generally
The Health and Social Care (Wales) Act 2025 section 26 amends the ‘limits to social care’ provisions in the Social Services and Well-being (Wales) Act 2014 section 47. The amendment puts beyond any doubt that it is unlawful for local authorities in Wales to provide services for disabled people (adults and children) in situations described by the Court of Appeal in the 1999 Coughlan judgment. The truly dreadful 2022 Welsh Guidance ‘Continuing NHS Healthcare. The National Framework for Implementation in Wales’ for adults and the equally lamentable 2020 Welsh Government ‘The Children and Young People’s Continuing Care Guidance’ made play of the fact that this was not the case (at para 4.12 and para 3.46 respectively) – a point that has been, in practice, exploited by Health Boards . It is to be hoped that this amendment will provide an opportunity for the Welsh Government to take decisive action to revise these highly problematical sets of guidance.
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Photograph of Gwawr-Pen-llyn by Richard Jones -@lluniaurich
Posted 11 April 2025