Disabled and elderly people face ongoing problems in accessing NHS long term care, an official watchdog has said.

In a report published on Thursday, health service ombudsman Ann Abraham called for "clear and consistent national guidelines about who is eligible for funding".

She also said there should be robust approaches for assessing need, and enough people in place with the right skills to undertake that assessment at local level.

The report is based on evidence gathered from almost 4,000 complaints received since the publication of the ombudsman's first report on the subject in February 2003.

"From the patient's point of view applying for funding for long term care has been a lengthy hit and miss process," said Abraham.

"My main concern is for the future. I want to be assured that no-one has been wrongfully denied NHS funding for their long term care and that the lessons learned from the current review of cases are used to make sure that open and fair procedures are put in place across the country."

Leadership

She added a recent ministerial statement "opens the way to improving how funding decisions are made and it means that the Department of Health is giving the leadership and guidance so badly needed by the health service locally".

The report called for clear, national, minimum eligibility criteria which are understandable to health professionals and patients and carers alike - a move which would have an impact on the public, private and voluntary sectors.

It also urged a clarification of standards for record keeping and documentation, and said that there should be more support for training and development to expand local capacity.

"Our report highlights that the only way to make the system transparent and fair, is to have national minimum eligibility criteria, with a national set of assessment tools and guidance on how to conduct and report on the reviews," added Abraham.

"It is clear from our work that there are examples of good practice and systems in some strategic health authorities which can form the basis for this work.

"We would be delighted to work with the Department of Health and the strategic health authorities in helping to develop national guidance."