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Public turn to CAB for help navigating the community care system

12 September 2012

Bemused patients and their families are turning to Citizens Advice Bureaux to help them get to grips with the community care system, new data shows.

Nearly a third of the 74,000 health related queries dealt with by CAB in England and Wales in 2011/12 were about problems with community care which covers a range of services from meals on wheels to home help.  

Availability of community care services was the biggest issue with almost 4,000 queries. Charges and payments was the second largest cause for concern with over 2,500 problems.

Costs for other health services were also creating conundrums for some patients and their families. Overall 13% of health issues dealt with by CAB were about NHS costs and a further 5,700 queries were about charges for other services including residential care.

The quality of care received by patients from a range of health services was behind 2,600 queries and there were over 3,600 issues of clients wanting to make complaint about local health services.

Plus one in ten of all problems were with residential care.  

Citizens Advice Chief Executive Gillian Guy said:

"Local CAB are often the first point of call for people trying to negotiate community care.  It can be hard for people to know where to start and is often made extra difficult when the situation is urgent and they feel under pressure.  But bureaux can help people understand the system and give practical advice on how to organise a carer or figure out a nursing home’s charges.  And if a bureau identifies a persistent problem with a service or system, it can raise the issue with the local health services and help them resolve it so other patients and their families don’t have to face the same challenge."  (See case studies below.)

A third of CAB clients are disabled or have long term health conditions and around 40% of bureaux outreaches are based in a health setting - from GP surgeries to mental health services and hospitals to community health hubs.  Plus over one third of bureaux carry out visits to people in hospital.  This puts CAB advisers in the right place at the right time when it comes to supporting patients and their families at difficult times.  

Norfolk County Council has already harnessed its local CAB’s insight into patients’ perspectives on local health services.  Norwich and North Norfolk CAB is part of consortium of organisations set to deliver Healthwatch in the county.

Steve Cheshire, Chief Executive of Norwich and North Norfolk CAB said:

"We’ve already had good links with the other charities and partners who are involved in the consortium so its a natural fit for us to be part of Healthwatch. Plus we have a number of outreach services based in medical settings so in many ways we have been playing our Healthwatch role before the scheme began."

The bureau will be giving general advice and signposting of local health services to clients both at the bureau and through outreach sessions.  And being part of the governing board gives the CAB a platform to speak up on behalf of clients and patients when there are problems – whether there is a delay in referrals between services or patients are not getting the financial support available to them.


Case studies

GOSH CAB makes it easier for parents of sick children to get the financial help they need

Great Ormond Street Hospital (GOSH) CAB found that parents of sick children often have to stop working in order to look after their child – leaving them with greatly reduced incomes at an incredibly distressing time. Yet when they tried to claim income support their claims were initially refused, although all of these were awarded on appeal.

The appeal process often took several months leaving families with seriously ill children without basic financial support and often with problems of rent, mortgage and council tax arrears.  GOSH CAB successfully persuaded the service provider, Jobcentre Plus, to change its information system for phone-line staff so that it could make sure the correct decisions were made about parents’ entitlement first time. The bureau continues to monitor the quality of decision-making further down the line.

Combined Hospitals CAB in Manchester ensures that people get the care they need once they are discharged from hospital

Ellie* is nine and looks after her mum Jane* who has multiple sclerosis and her two younger brothers aged three and four. Jane is permanently in a wheelchair and on some days cannot get out of bed as the pain is so severe.

Jane was threatened with court action by Ellie’s school for non-attendance leading social service to raise child protection issues.

A CAB adviser arranged community care and child in need assessment which resulted in Jane being offered a personalisation budget of £12,500 per year so she can now employ a personal assistant for help with everyday care needs and attend teacher training college. With support from a child carer mentor Ellie has had 12 months at school with no absences.

*names have been changed.

Notes to editors:

  1. The Citizens Advice service comprises a network of local bureaux, all of which are independent charities, the Citizens Advice consumer service and national charity Citizens Advice. Together we help people resolve their money, legal and other problems by providing information and advice and by influencing policymakers. For more see the Citizens Advice website.
  2. The advice provided by the Citizens Advice service is free, independent, confidential, and impartial, and available to everyone regardless of race, gender, disability, sexual orientation, religion, age or nationality.
  3. To find your local bureau in England and Wales, visit You can also get advice online at
  4. You can get consumer advice from the Citizens Advice consumer service on 03454 04 05 06 or 03454 04 05 05 for Welsh language speakers
  5. Citizens Advice Bureaux in England and Wales advised 2.3 million clients on 5.4 million problems from October 2013 to September 2014. For full 2013/2014  service statistics see our quarterly publication Advice trends
  6. Citizens Advice service staff are supported by more than 21,000 trained volunteers, working at over 3,000 service outlets across England and Wales.