Many don’t realise that people with a “primary health need” should receive full funding for their care home fees from the NHS. This is called NHS Continuing Healthcare Funding (NHS CHC) and those who are eligible are entitled to it regardless of how many assets they have.
Getting the NHS to admit that someone has a primary health need is another matter, however. It can take months or even years of persistence and the ability to present strong, evidence-based arguments. In a recent case that made the national papers, Don Keiller described an “arduous two year struggle” to prove his mother qualified for NHS Continuing HealthCare.
As a specialist solicitor’s firm specialising in care fees recovery, Just Caring Legal helps families who are applying for NHS Continuing Health Care funding. Here are our top three tips for securing NHS CHC funding for your loved ones.
Don’t believe everything you are told about NHS Continuing Health Care
You may hear that your loved one “won’t be eligible” for NHS CHC because they are not “at death’s door” or they have to be “PEG” fed or that someone has already carried out an NHS CHC assessment and they don’t qualify. But there are rules about the assessment process which the NHS has to follow. If they do not comply you can challenge this.
Keep a detailed journal and fill it in every time you visit
Don’t always rely on care home or hospital records if they omit vital evidence. Check them first to make sure they are accurate. Keep your own detailed notes of your loved one’s health condition and care needs, especially in the vital NHS CHC “domains”. (Sample of the checklist tool to start the process). Check the care records every visit and cross reference these with your journal to ensure they present a true and full picture. If they don’t, challenge and question those in charge of the care.
Be persistent
Many CCGs may possibly be making decisions on NHS Continuing Health Care based on budgets rather than real needs. It is often only those, like Don, who challenge these decisions based on evidence – and keep challenging –that succeed. If you feel you need a stronger voice, choosing Just Caring Legal to act on your behalf will maximise your chances of receiving NHS CHC. We can also help you seek a refund if you have already paid care fees. Contact us today on 01915 561 078 or email [email protected]