Dear Angela,after mum’s CHC assessment we were told she needed 24hr nursing care,she scored 1 high and 5 moderates in the care domains so she did qualify for some NHS funding ie. How long do they have to write up the review and inform us of the decision? Abbreviated to LAN. I have in mind appealing the original decision not to award Continuing Health Care. I was fighting a losing course . She went into the home in June 2012 and they are refusing her CHC because they say they have no evidence to prove her behaviour. We were awarded Fast Track Continuing Healthcare (CHC) one year ago. See page 133 paragraph 9 of the National Framework, which states that funding should be backdated to “day 29 of the period that starts on the date of receipt of a completed Checklist (or where no Checklist is used, other notification of potential eligibility for NHS continuing healthcare)…” Also, the second DST you may be offered does not constitute a new assessment process – it is a continuation of the original one, so the above still applies. What I mean is that the review must be done properly and all domains fully explored and all care needs properly assessed – and by the right people. The Framework makes that clear on page 16, paragraph 36: “Each of these characteristics may, ALONE or in combination, demonstrate a primary health need…”, Although my late mother was found eligible for CHC at her last assessment this was revoked by the CCG and my appeal was unsuccessful. TIA, Kevin – Clinical Commissioning Groups (CCGs) remain responsible for Continuing Healthcare assessments and decisions. 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. We were given a prognosis of 6 months, more or less. However, you don’t need medical knowledge to appeal, and you can dispute any decisions you don’t agree with. My Mothers case has now been rejected at Independent Review Stage where their response was to just to repeat the grounds around the original outcome. It’s a question of building a strong case, domain by domain, highlighting why the needs represent a primary health need and challenge every single thing that has been done incorrectly. 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. It is a worry and I got upset at the meeting as I felt they had it all panned out. We have gone through the Checklist and Mum qualified for Full Assessment after being placed in the A or B sections for most of the 11 areas. 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”. The longer you can keep going the better. Doppler effect (or the Doppler shift) is the change in frequency or wavelength of a wave. A standard psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses. At this point a form called the ‘Decision Support Tool’ (DST) is completed by a Multidisciplinary Team (MDT) – not just by one person. 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. As we lived some distance from my Mother-in-law, my sister-in-law used to deal with her welfare matters but she unexpectedly died. Many thanks. The Full Assessment placed her in High or Medium for seven of the Domains. I could go on. It comprises a series of rotations in different specialties within hospitals or in the community. £109/week,I am thinking about appealing because it was stated that mum’s medical problems were easily managed,, she has been in the nursing home for a month and was readmitted to hospital today because her oxygen levels are worryingly low and she is very drowsy it is difficult to treat because she retains carbon dioxide.I would be interested in your thoughts please. It cost him £82000. If they were to tell us after 6 months that funding was withdrawn would that be backdated to the date of the review and Dad would have to pay up for the last 6 months? My experience is that you will face a panel of up to 6 professionals, including (but by no means exclusively) those involved in the patient’s care. Required fields are marked *. However remember this is a health process on health needs- social services are able to offer a level of care too- washing,dressing, food provision, feeding and so on. Chris French, Thank you for your kind words. Well done for persevering. Wishing you well with your case, Mel. A small T-shaped device made from plastic and copper that is fitted in the uterus to prevent pregnancy. Foundation training precedes specialist training in medicine or surgery. I’m glad the website is helpful. She had serious dementia. A further funding review then takes place in 3 months, and after that it should be reviewed annually. I understand that the Ombudsman is only advisory and they cannot override an actual eligibility decision – only ask the CCG to review (yet again ). 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. Since then her condition has fluctuated, 2 more strokes, one emergency admission to hospital, all the time her condition does deteriorate. Any advice would be gratefully accepted. Our family have been to hell and back for the last few years and suddenly she is alright. It may also be caused by the rupturing of a blood vessel in or near the brain (haemorrhagic stroke). 3. the GP records provide insufficient clinical data upon which to come to a reasoned comprehensive conclusion (which is laughable because had several strokes) If you would like guidance or advice on this please contact us and we will talk you through the process. The science of computer information systems. When we received back the paperwork the cognition section had been changed ‘all persons present at the time of this assessment agreed a severe level of need, on reflection at the time of writing case coordinator felt this should be high level’ with the note ‘Mrs X comes across as being more cognitively aware than she has been reported to be by her family & carers’ . Dreadful. Hi Peter. I know which hospitals she was admitted to although the dates will be sketchy – do you think I will be able to get any information just based on her name and NHS number alone? 7. The CCG have now told me it is merely a review. The second assessment was done in June by our OT and the District Matron who took it upon themselves to push forward the second stage (with input from us too), as they could see that matters had become considerably worse. Also, if your husband scored several ‘Severe’ scores, it would seem almost certain that his care needs are well beyond the legal scope of the local authority. Fran – what utter nonsense from the CCG. So far the CCG have not provided the daily care records, G.P. My brother-in-law then took over the batten for a few years and then he also died suddenly. Just because I do not have all the laws to hand and I cannot afford a solicitor does not mean I do not have an understanding of the fact my mother HAD a primary health need. Gasp! Is this normal that gradings can be changed after the assessment? However they say it’s for 3 months from the date of our CHC Assessment back in January to the end of this month (March) where Dad will then need to be reviewed again! She has been in Carehome for 3 months and leading up to her assessment we noticed that her oxygen machine was taken away. That goes before the PB panel in the next week or so. It sounds as though you’re very determined, which is exactly what’s needed. Also known as hives, welts or nettle rash. We had no-one at the LRM and apparently they draught in a social worker from another county at IRP, who will not have any real idea of mums behaviours and case. This is the first in a six-part series on wound management. Finally, and if you haven’t already seen it, I would suggest that you take a look at the attached NHS document https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/770684/National_framework_for_CHC_and_FNC_-_public_information_leaflet.pdf She was then transferred to a lovely nursing home. S117 applies to her because she has been under S3 of the Mental Health Act and still requires Related Care. The appeal process is not arbitration as neither party have signed a legal obligation to abide by any decision and we consider the only real independent route is the Courts. The insertion of a tube into a part of the body, often a breathing tube into the trachea (breathing passages). She died within the week . I bought your book which is how she managed to get CHC in the first place. We have now had our CHC funding withdrawn and are at our wits end. Puncture of the wall of a body cavity by a hollow needle in order to draw off excess fluid or to obtain diagnostic material (eg abdomen or chest). Not verbatum! I am going to keep notes against an appeal if needed… also as you advise elsewhere. I have been trying for nine years – it has been very hard and stressful. When should NHS CHC checklist be completed? He was paralysed and blind in the left eye, doubly incontinent and in a dreadful state. I am fighting the NHS over the continuing funding for a 95 year old friend (I hold EPA) who has Parkinson’s and all the effects of this condition, suffered a few stokes, is completly immobile, unable to feed herself or drink, has severe swallowing difficulties associated with Parkinson’s, is doubly incontinent and has dementia plus others conditions. My understanding of the process was that my next step was to launch an appeal with NHS England which I did in October 2015, as yet I have had only an acknowledgement that they have received my request but I have heard nothing further. I told her we were waiting for a new checklist to be carried out in line with national guidelines and she told me that last week the hospital and trust had changed the checklist procedure and my father had no nursing needs. Not everyone is entitled to Continuing Healthcare (CHC). It strikes me that the local IRP is just down the road from our local NHS (who gave us the address in our ineligibility letter) .. and we worry about the supposed independence. You can also contact NHS England yourself, Jack. Where a member of staff is available to be called for work, usually outside normal working hours. Thank you. The swelling of the deeper layers of the skin, caused by a build-up of fluid. I would welcome any advice., thank you, Diane – what a shambles, and the behaviour of the social worker and the nurse is utterly appalling, not least in telling you to self fund. has anybody experience of this stage of the process??? By clicking Subscribe you also confirm you have read and accepted our Privacy Notice. 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. I could drive a truck through the holes in their decision, so it’s not like the meeting could possibly achieve anything. Sadly it seems very typical that an assessor will speak to the person being assessed for just a few minutes and then from that claim to have a full picture of need. Results for GCSE subjects in England are graded U to 9, with grades 4-9 being equivalent to GCSE grades C and above. The Community Mental Health Team / County Council are trying to get me sign agreement that is asking me to agree to be financially assessed for direct payments, in a Letter of Agreement, to see whether I need to make a contribution and for me try to enter into a contract. 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. A well-known example is in vitro-fertilisation, where sperm and egg are fertilised outside the body. The NHS must adhere to Dept of Health’s Continuing Healthcare review timescales in dealing with your request. My Mum had the checklist assessment on the 30th January but we have heard nothing since. Insist she stays in rehab until the full assessment process is finished – or they will have to pay for all care at this point. I refuse to give up. This article (above) takes you through the stages of the process. 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. Care To Be Different, The Copper Room, Deva City Office Park, Trinity Way, Salford, England, M3 7BG. A type of birth control. I am concerned he will eventually need a live-in carer should his health start to deteriorate. There’s something funny going on around stages 5 and 6 in the case of my appeal/s on behalf of my mother. Apart from helping to answer the questions on the original and second applications, we had no input into this decision and we have never met our Social Worker. They will offer students a mixture of classroom learning and 'on-the-job' experience during an industry placement of at least 45 days. After 6weeks we had a meeting with a nurse and a social worker who went through a series of questions and immediately told us she did not qualify for nursing care. She told me, in effect, not to bother to complain `as they follow the National Guidelines although each CCG operates differently`. You can also approach NHS England directly and ask for an Independent Review. i was told at CCG meeting i was entitled to panel however the ombudsman agrees with NHS. If these things haven’t happened, make a complaint to the NHS Continuing Healthcare team and also the Head of Adult Care at the local authority. And surely someone at the meeting should have actually known him/his health needs, medical history, and prognosis? You can also subscribe to this post without commenting. A network covering a broad area, ie any telecommunications network that links regional, national or international boundaries using leased telecommunications. It sounds as though they haven’t completed the Decision Support Tool (DST) properly and it’s unclear whether or not the assessor(s) have actually sent their recommendation to the CCG decision making panel. This article may help: http://caretobedifferent.co.uk/nhs-continuing-healthcare-assessments-2/. The team consists of community nurses, community matrons, physiotherapists, occupational therapists, specialist palliative care nurses, mental health nurses and health care and rehabilitation assistants. 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. Basically it’s all down to money and (as you will be aware) Continuing Health Care is expensive! They started the Continuing Care process for short term funding for her health needs (they were thinking a nursing home placement until the wound heals – she will require another operation for skin grafting in a few weeks’ time). Naturally we took over matters by which time m-I-l was in the care home. One of the questions was is he likely to fall, to which they put down no! She was not eligible for funding. The Acute Team nurse didn’t answer my desperate calls for help just as we were on the verge of needing hospitalisation ourselves for sheer exhaustion, my dad’s condition just kept on getting worse and I wanted him assessed for CHC again. Her original award was from Oct 2014 until her death in Jan 2016. You will be frankly amazed at some of the conclusions that the panel reaches about the existing condition and capabilities of the patient. Secondary care services are usually provided in a hospital or clinic. This will then be used subsequently for the basis of an assessment for Continuing Health Care. 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. You may be offered a Local Dispute Resolution Meeting first, but in many people’s experience this meeting is unlikely to change the decision. If your relative needs to be assessed for NHS Continuing Healthcare funding, you may be wondering what the different stages of NHS Continuing Healthcare assessment and appeal are. Thanks for stating denied attendance at an IRP is major flaw. Thanks I have seen this, its actually one of the things that caused me to raise my question. This means his care is by default an NHS responsibility and the NHS should pay (through CHC). Complaint letters all sit on file and are read, carfully, by the inpsectorate. She was being hoisted and was very confused. When Mum first entered the home she was ripping her hair out of her head, along with biting herself, lashing out at people and verbal abuse.
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