To ask the Secretary of State for Health (1) what alterations the Government plans to make to example 4 in the NHS funded nursing care practice guidance and workbook used by nurses in making their determinations about the correct band of NHS payment towards nursing care, in response to case E 420/00–01 ('Mrs. N') in the Health Ombudsman's recent report, NHS funding for long term care; (2) what alterations will be made to the criteria used by nurses in their determinations in relation to
(a) the higher band and (b) the middle band of NHS payment towards nursing care in the relevant guidance (HSC 2001/17) in order to ensure that they do not impose a higher test for nursing care payments than the Court of Appeal indicated in the Coughlan case was required for NHS continuing care. 
The case studies that are set out in the Practice Guide and Workbook assume that a continuing care assessment has already been carried out. These are Fictional examples that do not identify needs for other therapeutic or medical input. It is therefore not meaningful to compare these to cases identified in the Ombudsman's report, and I do not consider that there is any need to amend either the guidance or the guide.The recently issued guidance on NHS Funded Nursing Care (HSC 2003/6: LAC (2003)7) emphasised the distinction between National Health Service funded nursing care and NHS continuing healthcare very clearly. It stresses that all the individual's needs for medical and nursing care, as well as therapeutic and personal care, should be examined. Based on this examination, it highlights the need in every case to consider whether the person meets the criteria for fully funded NHS healthcare, before there is any consideration of NHS funded nursing care as part of a mixed package of care.