Google Adwords 0808 278 1398 Bing Ads 0808 274 4482

Continuing Healthcare Success!

We recovered over £60,000.00 for a family forced to use their own money to pay for a loved one’s care.

In this case, it was clear from our first meeting with the client that they had been let down by the system and left to fend for themselves. As a result they were paying over £8000.00 per month for their Father’s care: half to meet the ‘normal’ care fees – even though Dad’s savings were well below the local authority threshold – and half to pay for one to one support for Dad, as his behaviour was putting himself and others are risk. Such were the costs that the family had sold their own property to meet the fees. They had done their research and requested a continuing healthcare assessment, but there were delays of 8 months before this took place. The baffling outcome was that continuing healthcare would only pay for one to one care...and still no local authority assessment was forthcoming. To top it all off, payment for the one to one care was not forthcoming from the Clinical Commissioning Group, which meant that family still had to keep paying.

We represented the family in all aspects of their claim: chasing payment for the one to one care, appealing the original decision and submitting a retrospective claim. Initial correspondence with the Clinical Commissioning Group was followed by many, many phone calls and chasing letters, resolutely emphasising the law in relation to continuing healthcare and after a year of work funding was finally awarded. 

And the problems with continuing healthcare continue... 

Judy, our Clinical Adviser  - and former continuing healthcare assessor - rightly describes the issues surrounding continuing healthcare as so much more than assessment/appeal/ review. Holding Clinical Commissioning Groups to account is a major part of what we do.
As is often the case, those arranging and paying for their own care often miss out on vital help, as this recent case illustrates:

Janice contacted us after facing difficulties getting her Aunt Carolyn referred into the continuing healthcare assessment process. Carolyn lives in a residential care home and when her health deteriorated Janice asked for an assessment on her behalf. In these circumstances a residential care home requests that a checklist is completed by either a District Nurse or Social Worker from the local authority (as they are not a nursing home, they do not employ a Registered Nurse who could do this). However, as Carolyn is a self funder she is not known to the local authority, nor does she receive a service from the district nursing team. As a result, both services declined to get involved and Janice was understandably at her wits end. When Janice instructed us we encountered similar barriers so took the matter up with the local Clinical Commissioning Group. We are pleased to say that following our discussions with them, which led to them conducting their own investigations, they agreed that access to continuing healthcare assessments for self funders is problematic and that they would be instigating further training and altering current practice as a result. Given that Janice is one of a number of clients we have supported having difficulty accessing assessments we look forward to the process being made easier.

...and there are issues with funded nursing

The funded nursing care contribution – a fixed (non means tested) weekly amount payable by the NHS to nursing homes, to cover nursing care – used to be more or less assured for residents living in a nursing home. However, there are increasing reports from providers and families that this funding is being withdrawn, leaving care homes with financial shortfalls that families then have to pick up, or face moving their loved one.

Challenging a withdrawal of this funding is done via the Clinical Commissioning Groups complaint policy: contact a member of our team if this affects you for more information. 

Expert legal advice you can rely on,
get in touch today:

Please let us know you are not a robot