Appealing DST for NHS CHC funding

One of our family is about to try for continuing care for her Mother. She has COPD, Lewybody, other dementia, can't get about at all, various other conditions, and lives alone. I can see this thread is mainly about appeals which is quite worrying! but has anybody any tips for the initial claim? I know it's not going to be at all straightforward.

Hi Luckygirl. We’re looking at a retrospective claim for NHS CHC. I’ve compiled a long report presenting the facts, by using all the evidence we have. I considered the four key indicators, while I was working through the domains. I think the difficulty is knowing how it should be worded to prove eligibility for healthcare, rather than social care. Is there any advice you can give me please? Many thanks.

YES! - I had the letter confirming that my OH did qualify just the other day. He died in Feb. 2020, but covid had delayed the hearing.

It was done on zoom, and the people involved were all independent - from neighbouring authorities - and none had been involved in the original decisions.

Success was due to:
- meticulous presentation of the facts
- basing the appeal very specifically on on the criteria
- mustering evidence

It involved me in a massive amount of work. Luckily I used to be a hospital social worker and knew the system, so I was able to be very clear about how he fulfilled the ctriteria.

I ran my appeal document past Beacon (who provide a free limited time for phone advice) and they endorsed it.

The panel were very fair - they asked sensible questions, and I answered honestly and clearly. They related their questions to the document I had submitted, and they took on board what I was saying - I had been very clear about which domains I felt had been underestimated - and they agreed with me.

dragonfly46 - I think that was my thread you are referring to.

If I can share any advice on all this then do not hesitate to pm me.

There was a thread on this the other day where someone (I won't mention their name) had been successful at appeal. Maybe see if you can find the thread.

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Yes Hetty, I agree, absolute shambles. Very disheartening and depressing.

The CCG have done all they could in meddling and delaying the first stage, I just hope the independent panel are exactly that ‘independent’ . I’m giving it a go, at least I can feel I did all I could.

We used a specialist solicitor (no win, no fee) and still lost! The system is broken when somebody disabled, helpless and confined to a wheelchair, due to a stroke, doesn't 'qualify'!

Too many different reasons to be able to offer advice tbh. Even if we knew who you were speaking about, age, circumstances etc it would be hard for any of us to advise.

All you can do is go for an independent review t.b.h. Others experience won't necessarily help your situation. Good luck though with your claim.