Just Caring Legal has won an appeal for NHS Continuing Healthcare funding on behalf of a Northumberland family after exposing a catalogue of flaws in the assessment process.
“We won our appeal five months after the death of my wonderful, kind, gentle father in law,” the client said. “Ros was a lifeline. Her support through this process was fantastic.”
Family told relative would have to pay for care “because he could afford it”
The family approached Rosalind Hughes, founder of Just Caring Legal, following a chance conversation with a friend. They needed help after NHS commissioners told them they would have to pay full care fees for one-to-one nursing care for their father in law “because he could afford it”. Northumberland CCG refused to pay NHS CHC even after a multidisciplinary assessment panel had recommended he was eligible.
“After delving into the case I found there had been many procedural flaws in the assessment process,” Rosalind explains. “For example, the CCG did not inform the family that the assessment process was taking place in hospital. They did not invite them to attend even though this is clearly a part of the process under the National Framework.
NHS CHC is not subject to means-testing
“NHS CHC is not reliant on a means test – money and assets don’t come into it at all. Yet the family had to complete a financial assessment. The CCG said they would have to “get him out of hospital as he could pay for his own care”.
“Unfortunately this sort of thing is very common – clients are often not aware that they should not disclose financial information before a CHC decision. It is irrelevant.”
Challenge relied on specialist knowledge
Just Caring Legal’s specialist knowledge allows us to challenge NHS CHC assessment decisions that are not supported by sufficient evidence. “We were able to force the CCG to accept that they could not support the view that the patient did not have a primary health need,” Ros explains. “Nor could they back up their assertion that there were “exceptional circumstances” that meant they did not have to follow the recommendation of eligibility.”
The successful client added: “The process of getting CHC funding is just ridiculous – no wonder so many give up. Without the support from Rosalind and her in-depth knowledge, we would have given up.”