Definition of inpatient for DLA

Hi

I have a client who is staying overnight in hospital.  However, they are being allowed home frequently and spend about 40-50 hours a week at home.  Will they count as an inpatient for DLA purposes?

The Social Security (Disability Living Allowance) Regulations 1991, regulation 8 states the following:-

Hospitalisation

8.—(1) Subject to regulation 10, it shall be a condition for the receipt of a disability living allowance which is attributable to entitlement to the care component for any period in respect of any person that during that period he is not maintained free of charge while undergoing medical or other treatment as an in-patient–
(a)in a health service hospital, within the meaning of the NHS Act of 1977 or the NHS Act of 1978; or .
(b)in pursuance of arrangements made, or having effect as if made, by the Secretary of State, or any body in the exercise of functions on behalf of the Secretary of State under either of those Acts, in a hospital or similar institution; or .
(c)in a hospital or similar institution maintained or administered by the Defence Council or a National Health Service Trust; or .
(d)in a hospital or similar institution in pursuance of arrangements made by a member of a recognised fund-holding practice. .
(2) For the purposes of paragraph (1) a person shall only be regarded as not being maintained free of charge in a hospital or similar institution during any period when his accommodation and services are provided under section 65 of the NHS Act of 1977 or section 58 of, or paragraph 14 of Schedule 7A to, the NHS Act of 1978, or paragraph 14 of Schedule 2 to the NHS Act of 1990.
(3) In this regulation–
“National Health Service trust” has the meaning assigned to it by the NHS Act of 1990;
“recognised fund-holding practice” shall be construed in accordance with section 14 of the NHS Act of 1990.

If reg 8 bites then they are in patients.  However, days when the person goes into hospital and the days on which they come out are not classed as days of being in hospital.  And the linking rules will apply in the usual manner.

I am interested in this thread as I have a client in a similar situation. 
If I am reading this correctly it must follow that on the ‘day release’ days, however long or short, there is entitlement to DLA as that is the day they come out and go back in to hospital.  The DLA should then be calculated on a daily basis.
However does it matter that they are not being ‘discharged’ and ‘re-admitted’ on those days as I can see a problem when DLA checks with the hospital for dates.
My client [during a previous six month stay]was sleeping at home for one or two nights on occasions and DLA was being calculated at a daily rate after they confirmed this with hospital records.
Now she has been re-admitted [for a further six month stay] and is only home for a few hours at a time a few days a week and payment of DLA has been stopped.
It appears I should be disputing this.

nevip - 23 March 2012 03:25 PM

If reg 8 bites then they are in patients.  However, days when the person goes into hospital and the days on which they come out are not classed as days of being in hospital.  And the linking rules will apply in the usual manner.

Thanks for your help Nevip.  Does a day when a patient is left out of the hospital for part of the day, count as a day when their not in hospital?

I’m not sure about that off the top of my head.  I think I remember reading a CD a while back that said that they remained an in patient on such days.  However, I might be making that up.

That was certainly the case when I worked in a WRU in a psychiatric hospital a while back i.e. day-release was not counted as a day in hospital. This was a good few years back mind.

Edit, sorry, I think I am mis-remembering. It was overnight stays that didn’t count, I think day-release, where a patient returns to sleep at night, is counting as still being a day in hospital.

I was pretty sure I didn’t make it up.  See CDLA/11099/1995.  Whether the decision is ‘right or wrong’, in my view, its ratio survives the later addition of para 2A of reg 8 of the DLA Regs.