Is there anything else I can do? Enables scientists to examine molecules and atoms at the smallest possible microscopic level. A type of birth control. In Telford and Wrekin you will be invited to attend a vaccination appointment at a local GP service, a local hospital service, a local pharmacy or at a large vaccination centre. Kind regards A problem with the body’s immune system, when it starts to attack healthy cells, tissues and organs. You can also subscribe to this post without commenting. We bought your guidebook and studied all your videos etc about NHS Continuing Care and after a very long assessment meeting, in which we kept going back to the lessons we learned from your stuff, we were granted funding for Dad. A regulatory body that maintains a register of a number of healthcare professions. Unfortunately this is probably going to be the case. Angela, I bought the excellent ‘How to Get’ document & will follow it closely (following the Assessor’s opinion that my father does not qualify for CHC). In addition, the ‘new’ Checklist for your mother seems to be inappropriate and designed to make it less likely she will secure the funding. Just over a year ago she was admitted to hospital and we were told she could not go back to the care home and was being placed in a 6 week assessment bed at a care/nursing home. I can’t say if it’s worth appealing without looking into an individual case but if you know the needs were downplayed and the scores are wrong then start an appeal. Techniques conducted in a laboratory setting, where a glass dish or test tube is used for observations made outside the body. Sadly, nothing surprises me any more about the way some assessments and reviews are carried out, and the lack of information and response from the NHS. Treatment of cancer patients with x-rays or other radiation. Thanks, Hi Simon – anyone can request a checklist assessment to be carried out at any time. If your mum was in nursing then the NHS fund the nursing element anyway. Regional anesthesia techniques that are sometimes employed as an alternative to general anesthesia for surgery of the shoulder, arm, forearm, wrist and hand. Is it worth going to press with this or local mp or just give up. Not everyone is on computers. I absolutely agree that not one penny should be spent taking disputes further by getting legal firms involved. You will be frankly amazed at some of the conclusions that the panel reaches about the existing condition and capabilities of the patient. Removal of healthy veins to be used elsewhere in the body. Ok- but what I’m saying is that if it’s gone to review and there was no evidence there is unlikely to be evidence further down the line. Thank you Stressing that x will (at the time) be subject to a re-assessment of her needs under legislative framework of the Care Act 2014.”. TIA, Kevin – Clinical Commissioning Groups (CCGs) remain responsible for Continuing Healthcare assessments and decisions. I do not want the family home sold or him to go into a Nursing Home. Foundation training precedes specialist training in medicine or surgery. Also known as a “mini-stroke”, this occurs when there is a brief interruption of the blood supply to the brain, causing symptoms similar to those of a stroke. Often known as steroids, they are prescribed for a variety of conditions, via tablets, injection, inhalers, creams and so on. 6) If this Local Dispute Resolution process results in the decision of ‘ineligible’ being upheld, let the local NHS know that you would like an Independent Review Panel to be convened at regional level. A placement within a suitable establishment that provides the care “in house”. 5) If you’re ineligible at the DST stage, you can submit a Continuing Healthcare appeal via the local NHS. It didn’t matter what I said they have their own conclusions. The government will release a new date for back dates chc or you can dispute. My Mum had the checklist assessment on the 30th January but we have heard nothing since. A system that incorporates processes to minimise all risks in an organisation. Most assessors act wrongly in assessing ‘managed needs’ instead of the underlying needs, even though it’s clear in black and white in the CHC guidelines that assessing managed needs is entirely flawed. Is it normal to review CHC using the DST? Thank you. Despite significant advances in wound care technology in recent years, very little attention has focused on the use of cleansing solutions. The review meeting happened without us knowing the following day as I complained to her doctor . Care To Be Different, The Copper Room, Deva City Office Park, Trinity Way, Salford, England, M3 7BG. Treatment given in a large regional hospital that provides highly specialised care, for example in cardiac surgery or oncology. We completed the full assessment paperwork today. Your thoughts would be greatly appreciated. Any advice or comment you may be able to give would be really appreciated. Rose. Devices worn in shoes either to change the way the foot works while walking or to provide support. My current Social Worker who has recently assessed me for Adult and Community Services – My Care and Support Plan for Support Plan Budget (direct payments) – who I see rarely, will not support the Care Plan that was submitted by previous social worker that stated I would need people to either come in my father’s house/my home several times a day or have a live-in carer to look after me. Continuing Healthcare (CHC) was awarded for part of the placement – potentially on decline in health status. My husband has just been turned down for CHC funding, after a 9 month wait since the original application. A procedure used to examine the inside of the uterus (womb). The Royal College of … So far the CCG have not provided the daily care records, G.P. General Osteopathic Council - the regulatory body for osteopaths in the UK. Computerised tomography scan. (The agency seem confused and the CCG nurse does not know who they are or what is happening. How easy is it then to claim the money owed? 5. The symptoms typically last less than one hour and are completely resolved within 24 hours. The Health and Care Professions Council. Subsequently I have had a phone call from the social worker (still haven`t met her) who asked lots of questions (my carer`s assessment perhaps ?) Last week I participated in a meeting with an NHS assessment nurse and my father, who is in a nursing home in Gillingham, Kent to see if the NHS would contribute to my 92 year old fathers nursing fees. Thanks I have seen this, its actually one of the things that caused me to raise my question. Sending you and your family my best wishes Bev lowe, So sorry Bev So a woman in her 80’s with very bad vascular dementia who has documented behavioural issues before entering the home, suddenly stops all the behavioural issues until a diary is kept and the behaviours suddenly start again? Is that correct would you know please? A series of potential diagnoses that could explain the symptoms a patient is experiencing, which can then potentially lead to the correct diagnosis. Can I just check – does my mum have some rights to remain there until the process is completed? If your not happy first stage is local resolution panel, then independent. What can we do. Anonamlous – yes, the Continuing Healthcare process generally starts with a Checklist assessment, whether that’s for you or for your father. A period of time (often 6-12 weeks) spent away from a medical degree on a placement, often overseas. The decision should be made within 28 day of the initial Checklist assessment. See point 2 below. I have a question about the procedure aspect of the DST: In the DST I attended, it consisted the Assessor, the matron of my father’s nursing home and myself(he has multiple health issues including heart & kidney failure & dementia and is immobile, doubly-incontinent in a bed able to do little more than raise a beaker to his mouth). This may help – the timescales were announced at the same time as the deadlines for retrospective claims. However, you don’t need medical knowledge to appeal, and you can dispute any decisions you don’t agree with. assessment for NHS Continuing Healthcare funding, A social worker or other local authority representative must be involved, put together in writing all your reasons for disagreeing with the decision to deny Continuing Healthcare funding, What guidelines should be followed in Continuing Healthcare assessments, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/770684/National_framework_for_CHC_and_FNC_-_public_information_leaflet.pdf, http://caretobedifferent.co.uk/override-national-continuing-healthcare-guidelines/, http://caretobedifferent.co.uk/nhs-continuing-healthcare-funding-28-useful-links/, http://caretobedifferent.co.uk/how-do-you-know-if-a-continuing-healthcare-assessment-should-be-done/, http://caretobedifferent.co.uk/nhs-continuing-healthcare-should-social-workers-be-involved/, http://caretobedifferent.co.uk/care-act-2014-helps-you-with-nhs-continuing-healthcare/, http://caretobedifferent.co.uk/check-the-language-used-in-continuing-care-assessments/, http://caretobedifferent.co.uk/continuing-care-assessments-2-frequent-mistakes-part-1/, http://caretobedifferent.co.uk/appealing-a-continuing-care-funding-decision/, http://caretobedifferent.co.uk/care-notes-not-scratch/, https://www.youtube.com/watch?v=yiN5cK50FS0, http://caretobedifferent.co.uk/nhs-continuing-care-review-process-new-timescales/, http://caretobedifferent.co.uk/getting-the-nhs-continuing-healthcare-assessment-process-started/, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213137/National-Framework-for-NHS-CHC-NHS-FNC-Nov-2012.pdf, http://caretobedifferent.co.uk/nhs-continuing-healthcare-assessments-2/. Abbreviated to LAN. When you subscribe you’ll also receive a link to our free e-guide, “The 7 Costliest Mistakes Most Families Unwittingly Make With Care Fees – and 5 tips to avoid them”. Sets out the rights that patients, the public and staff are entitled to, and the pledges that the NHS is committed to achieving. Agenda for Change. Meanwhile the CCG nurse has put forward an application that we are paid on the Personal Budget (PB) funding channel. And we haven’t even got as far as the checklist being done properly yet! What do we do now ? In the meeting she was graded as 1severe, 3high, 3moderate, 4low. The science of the functions of living organisms. I could go on but we are asking how on earth this cannot immediately qualify as “primarily” in need of “healthcare” We just despair at her situation and wonder how on earth the NHS (who dismissed her from a hospital bed because there was no more they could do for her) will not readily pay up. Thanks for stating denied attendance at an IRP is major flaw. A regulatory body that maintains a register of nurses, midwives and health visitors. Not everyone is entitled to Continuing Healthcare (CHC). The main pay system for staff in the NHS, except doctors, dentists and senior managers. The NHS must adhere to Dept of Health’s Continuing Healthcare review timescales in dealing with your request. I refuse to give up. Sometimes referred to as a CAT scan or computed tomography scan. She finally agreed the checklist would be redone. Endoscopic retrograde cholangiopancreatography (ERCP) is technique where a thin flexible tube with a light and camera is inserted via the mouth.It is mainly used to diagnose and treat bile duct and pancreatic duct conditions. There was also another section regarding medication which we felt was high and the assessor moderate & she said we would err on the side of caution but has scored on her sheet as moderate. The manager of the home informed me in October 2015 she had referred my Mum for an urgent assessment and still nothing has been done. Today I’ve had an email to say the DST has been scrapped as the checklist has been repeated and my mother found to have improved so she is not now needing any medical care. The local NHS appeal process resulted in another decision of ‘ineligible’, but they have made no mention of the independent review and only offered a meeting with a ‘senior manager’. If they are then, in mum’s case, in their opinion there wasn’t a need for such care, so they didn’t complete a checklist (therefore they did not go to a DST either) therefore care was provided by the LA. Catheters also have other uses, for example to widen obstructed blood vessels. I could drive a truck through the holes in their decision, so it’s not like the meeting could possibly achieve anything. Around 90% of patient interaction is with primary care services. You could write to the Head of Adult Care at the local authority and state very firmly that the local authority may be in an illegal position by not being in involved in looking at the legal limit for their care: http://caretobedifferent.co.uk/nhs-continuing-healthcare-should-social-workers-be-involved/ In addition, use the Care Act to highlight the NHS’s failings to the discharge team and/or the assessors: http://caretobedifferent.co.uk/care-act-2014-helps-you-with-nhs-continuing-healthcare/ Keep going if you can. Mairi – the attitude of the assessment team seems callous and uncaring in their disregard for your situation following your father’s death. It’s very hard to pass comment without knowing the full story. The repeated decision is that Mother required social care not health care. A Checklist can be carried out by one person – but that person must understand the process and be familiar with your relative’s care needs. In your Care fees document (which we have found such a terrific help and Guidance) there is regular focus on this term “primarily healthcare” and we just cannot understand why this has to be so minutely studied. A lot of stuff we discussed was cherry picked and stuff that we presented and discussed which was in Mum’s favour has been omitted from the “snapshot minutes” as the lady just told me they were. We have developed this glossary to explain these terms in more detail. Any advice on this issue would be much appreciated. It’s not the only one but they will investigate. A device used to administer drugs including corticosteroids for conditions such as asthma. You may also find this additional article helpful: http://caretobedifferent.co.uk/appealing-a-continuing-care-funding-decision/. The first year of training is known as FY1 and the second FY2. Take care – It hurts – been there before – Warmly, from a stranger – Kevin, Hi Christine My father is currently bed ridden, doubly incontinent, unable to feed himself and can hardly move. I am very active on a degenerative illness forum and regularly point people here and then if need be I support them to follow through on your advice. Can they do that, insist on repeating the initial assessment? Complaint letters all sit on file and are read, carfully, by the inpsectorate. What should my next step be ? Results for GCSE subjects in England are graded U to 9, with grades 4-9 being equivalent to GCSE grades C and above. I knew she was wrongly assessed and I think this was the final straw for her, Its hard, I am waiting for a similar loss. If you would like guidance or advice on this please contact us and we will talk you through the process. Regards nigel. It wasn’t until after her death that we found out that technically she should have been offered Continuing Healthcare. A procedure allowing the examination of the colon using a thin flexible tube with a light and camera at one end (known as an endoscope). My Mum is double incontinent cannot feed herself she does not know who we are now and is failing in health. It’s so so sad. Alternatively if we don’t accept a second DST, and continue our appeal to NHS England ….. and win (a big IF I know!) Mel – we don’t have one on the IRP specifically, but the same tips, information and advice that is on our website and in our book applies to IRPs. That was 4 months ago and we haven’t heard anything. My mother had a planned operation and has been left with a large abdominal wound. (a) there may be a need for such care, The LA & CCG seem to interpret ‘where it appears to that body that there may be a need for such care’ as the ‘clinical opinion of social & health professionals’. Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. A raised, itchy rash on the skin. Could you tell me how long it should be between the checklist being done and the full assessment? We have no qualified medical strength and cannot dispute such decisions but we know that Mum certainly needs 24 hour nursing care. A test that checks for problems with the electrical activity of the heart. If they refuse then you can download your own Checklist and complete it yourself. In fact, if he had lived another three years he would have died a pauper. As far as I can see, all these people at local level are misery inducing thieves and/or idiots and I just want to get a move on rather than suffer their delaying tactics and have to share the air with these people. We have just had the good news that Dad is eligible for CHC funding. 6 | Clinical guide for the management of virtual working in secondary care during the coronavirus pandemic Virtual appointments: planning guide Decide plan • Establish a virtual clinic trust project team. And as a result were told we are unlikely to suceed in our attempt for funding but of course we will try. She was being hoisted and was very confused. Actors may be used in place of real patients. I cannot afford legal advice at all. help. See National Framework page 27 paragraph 80: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213137/National-Framework-for-NHS-CHC-NHS-FNC-Nov-2012.pdf. The “scores” were 3x high, 1 x severe, 4 x moderate and 3 low. It should have been the Checklist to start with and, if your mum got through that stage, the Decision Support Tool. Considerable weight loss and obviously is in low mood because of this. She is obviously still terminal though, Could they take it away from her ? West Midlands. Your email address will not be published. Thank you for doing such a great job! They have agreed to fund the placement fully until the outcome of this review. Check out page 25 paragraph 74 of the National Framework: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213137/National-Framework-for-NHS-CHC-NHS-FNC-Nov-2012.pdf. This is the injection of local anaesthetic or other pain-relieving medicines into a space that surrounds your spinal cord. This is the first in a six-part series on wound management. This can involve answering enquiries over the phone, or physically attending the workplace. Best wishes Part of a doctor’s training and takes place after the completion of a medical degree at university. Well done for persevering. I have in mind appealing the original decision not to award Continuing Health Care. Fred – the process they’ve used is flawed. What was stated on the social/community reports presented by the social rep if they even attended. If you’ve already had an assessment and been turned down for funding, you can appeal. Let’s hope we win. She is in a nursing home and was fast tracked for continuing funding in February 2014 when the hospital advised she was dying. The previous Social Worker advised us in writing in September 2014 that the Direct Payments I receive will not be means tested as she is under Section S117 of the Mental Health Act which means that any eligible mental health aftercare (NHS / Social Services) should be split between the NHS and local authority via a funding panel and not at a cost to the service user. It is of course ludicrous to assume anyone can gain proper insights into a person’s needs and condition from a ‘quick chat’. If I think the ombudsman has made a wrong decision, can I take it to another solicitor (to take legal action)? Symptoms that indicate a potentially serious disease and warrant prompt investigation and treatment. 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The bedsore was looking miraculously better. I have been busy contacting all professionals involved with my husband`s care, GP, Consultant, Parkinson`s nurse, daycare manager,homecare provider etc to request supporting letters for the appeal. If a Review is granted, it will involve an independent chairman and officials from another area who have had no previous involvement in the case. The home is known in the area for taking the most challenging clients. I think that you will find that you are correct in your thinking, and that you must go through the checklist/Decision Support Tool (DST) process first. As the case has not gone to panel, you are unable to appeal the closure letter”. The meeting was a charade, a waste of everyones time and I wonder how so called ‘professionals’ can bring themselves to participate in such a dishonest sham. It talks about the full assessment being a checklist then, if passed, a DST and explicitly states ‘The first step in the assessment process for most individuals is screening using the Checklist Tool.’ Her original award was from Oct 2014 until her death in Jan 2016. She declined to answer the questions in the letter I had sent asking for clarification on which points we had fallen below the requirements and also said that it was a`closed` meeting so there were things she could not answer, i.e. If you have health needs/nursing care needs and you need full time care, you need an assessment for NHS Continuing Healthcare funding. Hello Peter, my partner of fifty years had a massive stroke in 2015. Thanks for mentioning the document, Julie. Insist she stays in rehab until the full assessment process is finished – or they will have to pay for all care at this point. 9) If you’re found ineligible for funding at the Independent Review, you can approach the Health Ombudsman. The NHS reviewer kept saying that the review wasn’t important as we had had the assessment meeting and this was just going to take 5 minutes to have a quick review. The National Institute for Health and Care Excellence provides national guidance and advice to improve health and social care. I also have photos and videos on my ipad but I am just hoping I will get the opportunity to show them. A group of GPs repsonsible for designing local health services in England. Our argument is that they have not paid for the previous ten days, despite his care needs being the same, do we have any right to appeal? My Mother is on Morphine constant patches. 1. records from the care home are no longer available A standard psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses. She has improved so that some days she is quite lucid and by sheer cussedness has improved walking to the extent that with the aid of a Zimmer frame and two people, managed to walk to the toilet. Many of us a grateful to you. Hear what our staff have to say about their NHS careers, Download resources to help you with your career decisions, Access a range of support and resources for the classroom. It has been established that `P` does not have a primary healthcare need of a nature … to meet the eligibility for NHS Continuing Healthcare Funding”. A sample of cells or tissue is removed from the body and tested to help exclude or establish a diagnosis such as cancer. Dad went into a home in September 2015 and he died there yesterday. Is that not the case? Some medical trainee pathway posts are such that, once the trainee starts a pathway, provided they meet the Annual Review of Competence Programme (ARCP), they will continue on that pathway until they reach the end of their training. One nanometer is a billionth of a meter. In two crucial domains, the nurse was offered the chance by the NHS Assessor the chance to “sit on the fence” & so no score was recorded from her. Risks to you. Examples include lupus and rheumatoid arthritis. We were denied our say in the IRP. A small T-shaped device made from plastic and copper that is fitted in the uterus to prevent pregnancy. Treatment for cancer patients with drugs that destroy the cancer cells. A solicitor’s letter may help at this point. It’s routine at 3 then 12 months. My question is are they correct? All content on the Care To Be Different website is copyright Continuing Care Solutions Ltd. What are the different stages of NHS Continuing Care assessment and ap... https://caretobedifferent.co.uk/wp-content/uploads/2013/03/Blank-elderly-lady.jpg, https://caretobedifferent.info/wp-content/uploads/2020/10/ctbd-logo.jpg. Nigel- have you followed local procedures? http://caretobedifferent.co.uk/nhs-continuing-care-review-process-new-timescales/, Thank you Angela. 7. The examination takes place via a series of stations usually lasting 5-10 minutes, and the student progresses from station to station with a different examiner each time. Normally it’s a couple of weeks for them to let you know. Relating to the whole thing rather than just a part. I contacted PALS and they gave me a contact who is `spokeswoman` for the Panel. We had an Independent Review Panel (IRP) – we were told a full panel was not required, they then told us my mum did not qualify. Medicines and Healthcare Products Regulatory Agency. I could go on. Please can you tell me how long I should expect to wait for a response and should I now take the matter to the ombudsman? a social worker) has a legal duty under the Care Act to refer a person for a Continuing Healthcare assessment if there is even a small chance the person may be eligible. This is borne out by the thousands of comments from families on this website. I have now been advised that a MDT will be held on 17 June 2015 as the NHS feel her condition has improved and that she should no longer be funded. Many people find this book a cost-effective starting point, It takes you step-by-step through the whole NHS Continuing Healthcare process, right from the start, including how to approach the NHS, what should (and shouldn’t) happen, the pitfalls to avoid, what to do and say before, during and after an assessment, what’s right and what’s not, how to challenge decisions, how to pull apart the NHS’s assessment notes, etc. On page 30 and top of the opportunities for change list which can be done immediately is: Both he and his wife are elderly and are simply not up to appearing before an appeal panel, but I am quite happy to represent them. How they can do that seems utterly stupid as they have no personal knowledge of the client. If they say no get the managers name and address and place a formal complaint (Formal complaints stay on record and form part of their quality audit undertaken by independent bodies such as the Care Quality Commission. A well-known example is in vitro-fertilisation, where sperm and egg are fertilised outside the body.
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