NHS continuing healthcare

Helen657 - it is so hard isn't it. My OH thought he was being cut up and put down the sewer. How to deal with that?

The fact that you are exhausted by it all and it is making you ill is exactly why so many people do not get what they are entitled to. They or their relatives just lose heart and give up - and who can blame them?

When it actually came to the appeal hearing (which was done on zoom) I cannot fault them. There was someone appointed by the health authority to be an advisor to me, and she and those on the panel were all independent and had not been involved with the previous decision - in fact two were from a different area. My appointee was very supportive and she pointed out things in my favour that I had missed. The panel were courteous and supportive, as they knew my OH had died, and simply asked me to clarify the items in my appeal. I had a DD with me who chipped in now and again. The panel had all his medical, home nursing and nursing home notes, and I had been sent these too so I could see where they were getting their information from. The appointee rang me the next day to say that they had granted the appeal - mind you I am still waiting for the money!

The appeal was granted posthumously.

Peasblossom

I agree with Luckygirl in regard to Helen657s post.

The principle seems to be to turn down the first application automatically. To turn down the second in the hope that you’ll give up and only to concede funding when you show you’re prepared or able for a fight.

If it’s given on appeal, clearly it should have been given in the first place.

It’s deciding whether the fight is worth it that’s the hard bit. I knew the time was limited for my husband so I decided not.

Thanks for the advice Luckygirl & Peasblossom
I have been debating what to do, both in regards to challenging the nursing home not deducting FNC & the CHC decision, unfortunately the last 2 years (& particularly the last 6 months) stress has made my sister and I poorly, so we’re just giving ourselves a chance to recover before deciding what to do.
Having mum beg us incessantly to “wheel me into the middle of nowhere and leave me to die” hasn’t helped our mental health. Thankfully she seems to have turned a corner and started to accept things!!

I have only praise for Beacon. I used their advice to launch my appeal. They studied the documents I sent them and I had a call to basically establish that I had a case. They then advised me on how best to word the appeal. I then sent them my wording and they spoke to me again to give advice on tweaks. The end result was that the appeal was successful.

The free phone advice they give is government funded. You only have to pay them if you ask them to actually take on the case rather than advising you on how to do it yourself. Their advice was sufficiently clear that I felt able to take the appeal on myself.

Luckygirl

Care to be Different are good and I used their book, which you can download.

Beacon actually give free advice from a solicitor over the phone - I think you can get 1.5 hours. So you can speak to someone and ask the questions that are relevant to your specific situation.

I tried Beacon even after having gone through another organization, CompassCHC; who carried out investigations into my Mum's care situation and actually produced a written report that my Mum does and should qualify for CHC....the CCG ignored it.

Beacon's 'free advise' is more to lure you in to paying for their services, as they ended up messing me about. The case worker was a lead manager, who was too busy getting back to me when I emailed them.

They have a very high threshold of who should qualify for CHC, only going all out giving the impression they can help with your case to get business.

Beacon seem to be funded by the Government to a certain extent, you only pay a 3/4% (three quarters %) - or so they claim.

Bottom line: Buyer Beware.

Care to be Different are good and I used their book, which you can download.

Beacon actually give free advice from a solicitor over the phone - I think you can get 1.5 hours. So you can speak to someone and ask the questions that are relevant to your specific situation.

caretobedifferent.co.uk/

www.facebook.com/CareToBeDifferent

caretobedifferent.co.uk/what-kind-of-care-needs-count-nhs-continuing-healthcare/

caretobedifferent.co.uk/the-coughlan-case/

Tonnes of information out there, but you need the heart of a lion to combat CHC nurses's twisted, well versed reasoning to avoid at all costs what the NHS is duty bound to pay for.

My Mum suffered severe Strokes May 2012 leaving her disabled with health complications including Dementia. All professionals involved, (including the Care Agency Manager who is an absolute nightmare dealing with on lots of issues, letting loose unprofessional 'carers' to carry out below standard 'care' and damaging my Mum's belongings/property in the process) have blocked my involvement supporting my Mum, especially for CHC funding - the local authority are breaking the law taking responsibility for her care and forcing her to pay; what by law is the responsibility of the CCG, but they have made me so ill dealing with things the only recourse is the Crowdfunding page I am praying my socks off will resolve things for sooo many families throughout the country. Local authorities will not be let off lightly for all the obfuscation they cause, when the following is ignored;

caretobedifferent.co.uk/nhs-continuing-healthcare-assessments-2/

Local carers centre useless - Carers UK same. I have so much pent-up frustration, wish I could use to create a charity that would rectify matters, but alas I am only one person and haven't got a magic wand to right so many massive injustices....but that day will certainly come, just have to hang in there in the meantime.

I agree with Luckygirl in regard to Helen657s post.

The principle seems to be to turn down the first application automatically. To turn down the second in the hope that you’ll give up and only to concede funding when you show you’re prepared or able for a fight.

If it’s given on appeal, clearly it should have been given in the first place.

It’s deciding whether the fight is worth it that’s the hard bit. I knew the time was limited for my husband so I decided not.

she doesn’t qualify for CHC (assessed May 2021) despite being paralysed by a stroke, needing turning every 2 hours, a hoist & 2 carers to transfer to/from bed, full care for every need etc.

It is highly likely that she does in fact qualify - it took to refused applications and a formal appeal for me to get CHC funding for my OH.

Talk to Beacon who will tell you how to reapply and what to say and do. www.beaconchc.co.uk/

They always say no first time and you need to pursue this

It is well known that self funders already heavily subsidise those whose fees are paid by the council.

If someone self pays full cost of care it seems very wrong that the funded nursing care is not deducted from that amount.

As Butterfly32 says, there are serious flaws, my mother is in a nursing home, she doesn’t qualify for CHC (assessed May 2021) despite being paralysed by a stroke, needing turning every 2 hours, a hoist & 2 carers to transfer to/from bed, full care for every need etc. The assessors said however that she did qualify for Funded Nursing Care (FNC) of £187.50pw, so we were glad that this would contribute to her costs as she is self funding only to find that the nursing home get paid it direct & don’t deduct it from the bill!!! Apparently they don’t have too!
We’d just moved her from a dreadful home which we weren’t happy with & had lots of other issues at the time (emptying & selling house) & we love this home so didn’t want to “rock the boat” & challenge them at the time.
So OP’s mum may be entitled to the lesser amount - FNC - even if not full CHC?
Good luck whatever you decide to do

NHS Continuing Health Care is for people that are elderly, frail, ill or disabled; as Luckygirl says for in any setting.

There is a national scandal, where people who should qualify slip through the system for financial reasons, who end up like my Mum as social care and are forced to pay all care fees.

NHS Continuing Health Care is being labelled as the NHS's best kept secret.

Please check out:

The NHS Continuing Healthcare (CHC) Scandal
www.crowdjustice.com/case/the-nhs-continuing-healthcare-scandal/

Vulnerable people are being denied vital health care, when they have paid into the system all their lives, but unfortunately not many people are aware that by law they are entitled to free care.

CHC funding can be paid in any setting, including your own home. It is of course more likely to be paid in a nursing home because it is based on health care needs.

If 19 days in care home fees which might be returned that may be quite a lot of money and worth looking into.
Continuing care is rarely paid for those in residential care, but even in a nursing home it is hard to get.

Thank you all again, good information. I agree time is more important at this stage. Just need to do 'due diligence' before disregard.

It is not means-tested - it is entirely based on whether there is a "health care need."

Contact Beacon: www.beaconchc.co.uk/
They give free legal advice on this and they have lots of information on their website.

Basically, if your mother meets all the health care needs categories, then she will be fully funded by the NHS, just as she would be if she were in hospital. There are lots of categories!

My OH was turned down twice and I appealed and won.

If you need any advice, please pm me. I have a brain full of info about it all!

Honestly I don’t think it would be worth the time and effort for 19 days, that might not qualify anyway.

Especially as you don’t think she has specific medical needs.

Spend the time with her, not on paperwork?

Thank you all for prompt answers. Nursing home thought she might be due a refund of costs of 19 days stay in May/June and maybe anticipating we might wish to avail of them again. So much paperwork! I think it is nursing care she needs now so will not qualify. No medical needs just very frail but still of sound mind at 101!

the assessment is biased trust me I had 3 hour zoom meeting last yearfor my continuing primary health care funding at home. I have terminal cancer and because I was at the time still able to fill a kettle and cook, clean myself my point score was low or zero for the most sections. But also means testing comes into it as well. But I have to also question as to why the nursing home has sent these forms, it would come from the relevant local council. Sound like an admin error to me

Tried with my Mum, who was in care, it’s a tortuous process, you need perseverance. I think it was Luckygirl on GN was successful?

NHS continuing health care isn’t means tested,

I’m not sure why the nursing home would send you this now she is living at home. Have they said why?

Continuing health care is not means tested but is based on medical needs. It funds those but not nursing care. It’s a bit complicated to get your head round which is which.

If your Mum needs help with personal hygiene, feeding, keeping mobile, not being left alone, that’s nursing care. If she needs a blood transfusion at home or dialysis that would be classed as continuing health care.

There is funding for nursing care but her assets would be taken into account.

Hope this is helpful.