An independent review for City of Stoke-on-Trent council highlights the ICB's plan to cut continuing healthcare (CHC) in 2025/26 by more than £40m through reducing the number of people who qualify and by cutting the size of existing care packages. 

The review shows CHC eligibility dropped by 27% in 2025 reducing the previous scope of coverage by 293 people.

A covering report by the council suggests that, in 2025/26, 53 CHC cases were handed back to the council with a full-year financial impact of £2.56m.

The analysis found the reduction in eligibility rates seen in the 12 months to September 2025 could leave the city council and local residents facing significant additional care costs if the ICB is wrong that ‘in the vast majority of cases… the savings involve reducing expenditure on care that does not need to happen'.

The review supports a reduction in ICB cuts to elective procedures carried out in private hospitals that left some patients with complications or conditions that cannot be treated in private facilities waiting longer. It warns cuts need to be managed carefully to ensure waiting time improvements are focused on patients who cannot benefit from care in the private sector. 

The report also notes narrowing the NHS definition of healthcare may mean transport, therapy, social activities and household help within personal health budgets falling on councils or individuals.

Councillor Joan Bell, chair of the overview and scrutiny committee, said: ‘We thank the Nuffield Trust for this important and clear review. 

‘We understand that the ICB faces very difficult financial decisions – but these must not lead to costs for vital care being passed on to the city council, or residents themselves. 

‘Ultimately it is for Government to ensure that there is proper financial provision to meet the health care needs of the people of this city.'

Dr Paul Edmondson-Jones, transition director for NHS Shropshire, Telford and Wrekin and NHS Staffordshire and Stoke-on-Trent ICBs, said: ‘We welcomed the opportunity to support the Nuffield Trust's independent review. It reinforces the need for the NHS, local authorities and the voluntary sector to work together to ensure limited resources are used in the best interests of our communities.

 ‘Our 2025/26 plan was clinically led, evidence based and designed to deliver fair, consistent standards of care within the resources available. The review confirms the plan was deliverable, applied national frameworks correctly and does not provide evidence of costs being shifted to councils or residents.

‘We value our partnership with local authorities and remain committed to transparent, joint working. We will continue to monitor impacts together and use evidence to make the best use of the resources we have, while protecting those most in need.'