Is the hospital trying to discharge your relative without a care needs assessment?
If so resist – or risk paying care fees when you shouldn’t. Is your elderly relative under pressure to vacate an acute hospital bed? Are they likely to have ongoing care needs, requiring either residential care or support at home? They should not leave hospital without a full NHS Continuing Healthcare assessment. The process of hospital discharge can be a barrier to receiving Continuing Healthcare Funding.
Many people don’t realise the full cost of care fees should be paid by the NHS where the person has a ‘primary health need’. NHS Continuing Healthcare Funding is not means-tested. In all cases, the care is free of charge.
So leaving hospital without an NHS Continuing Healthcare assessment means you risk paying for care that should be free. Hospitals are under pressure to cut NHS CHC assessments. Hospitals are now under greater pressure than ever from NHS England to avoid carrying out NHS CHC assessments before discharge. There is a specific target to ensure less than 15% of NHS CHC assessments are carried out in an acute setting.
Hospital discharge teams may say your relative won’t be eligible for NHS CHC.
Or, that they have already been assessed as ineligible. You should challenge this.
Anyone discharged from hospital has the right to at least a preliminary assessment for NHS Continuing Healthcare funding. That includes with the full involvement of their families. Insist on seeing the documentation if the hospital says it has already done this. Challenge their decision if you feel it does not accurately reflect the situation.
The discharge team may say it is not appropriate or possible to carry out an NHS Continuing Healthcare assessment in hospital as the patient’s care needs are not yet clear. They may say a period of rehabilitation or re-enablement is necessary first.
However, unless your relative’s care needs are likely to change markedly as a result of leaving hospital, you can challenge this. Part of the purpose of a Continuing Healthcare assessment is to ascertain what a person’s ongoing care needs are. This also includes what support may need to be put in place.
What are the actual rules here?
The National Framework says the (Clinical Commisioning Group) CCG should ensure that full assessment of eligibility is carried out “once it is possible to make a reasonable judgement about the individual’s ongoing needs”. Until the assessment happens, it adds, “the relevant CCG retains responsibility for funding appropriate care”.
Meaning, your relative shouldn’t pay for care until they have received a full assessment for NHS CHC. Letting the hospital know that you know this may help persuade them to carry out that assessment after all.
How can we help?
So are you coming under pressure to take a relative out of hospital without an NHS CHC assessment? With our specialist experience in pursuing complex care funding cases, Just Caring Legal can provide a strong and persuasive voice for families, constructing robust arguments to challenge decisions and ensure you receive the funding your relative is entitled to.
Get in touch with us today on 01915 561 078 or email us at firstname.lastname@example.org for a free consultation.