The Scottish Office Department of Health issued guidance in 1996 on ‘National Health Service (NHS) Responsibility for Continuing Health Care’ which is provided free of charge to patients whose complexity, nature or intensity of care needs (medical, nursing) are sufficient to fulfil certain criteria. Due in part to differing NHS guidance in England, there has been increased complaints to Health Boards and the Scottish Public Service Ombudsman (SPSO) about patients deemed not to fulfil the Scottish criteria.

To establish the level of knowledge amongst experienced psychiatrists about current Scottish regulations on NHS Continuing Care.

Following a pilot survey, a modified postal questionnaire comprising 19 structured questions was sent to 134 psychiatric consultants and specialist trainees in south-east Scotland in mid-2007, with a reminder to non-responders.

A 54% response rate increased to 66% following reminders. Of these, 82% were consultants and 88% had clinical responsibility for inpatient care within the past decade. Only 24% of responders were aware of the current Scottish guidance for NHS Continuing Care, with only 14% aware of the actual 1996 document. There was uncertainty regarding responsibility for both discharge and appeal processes although 8% had been involved with a formal complaint relating to NHS Continuing Care and 10% involved with the SPSO.

Clinical uncertainty abounds regarding the criteria in Scotland for NHS Continuing Care, despite guidance being issued over a decade earlier. There is urgent need for review of the criteria by the Scottish Government, with raised awareness among practising clinicians.