So, you’ve passed the checklist stage. Your relative is entitled to a full eligibility assessment for NHS Continuing Healthcare (NHS CHC). So, what now?
Every eligibility assessment for NHS CHC should involve a multidisciplinary team (MDT) of the main health and social care professionals involved in caring for your relative. Make no mistake. The MDT is the most vital part of the whole NHS CHC eligibility assessment process. It should be where all the evidence about your relative’s care needs is laid out and examined in detail.
However, the reality is often very different. The government’s National Audit Office says that in many cases, care needs are downplayed in the MDT meeting. This can be despite strong evidence. The report states that the views and judgements of certain professionals are ignored – or simply never requested. Assessments do not take into account all the relevant information, or are based on inaccurate information.
It is vital you are fully prepared for the MDT meeting. This is so you can maximise the chances of the decision going your way.
Our top tips for ensuring your relative gets the NHS CHC funding they are entitled to.
Get in the room.
The first rule of MDTs is to be in the room. Often, family members are not invited to the meeting, or invited at such short notice it is difficult to attend. But you have every right to be there, and to bring professional representation to maximise your chances of success. Insist on that right, and be ready to go at short notice, if required.
Do your homework.
Ideally, all the people in an MDT meeting should have a thorough knowledge of your relative, any conditions, illnesses or disabilities they have as well as the impact on their day-to-day life. This is often not the case. MDT assessments often don’t include professionals involved in the direct care of the individual or all the appropriate medical specialists. This can make it impossible to carry out a fair assessment.
You will need to be ready to fill in all the gaps. Get hold of a blank Decision Support Tool online and fill it in yourself, as fully as you can. Enlist the help of daily carers to include everything you think may be relevant. Concentrate on how their health condition affects the intensity, severity, complexity and unpredictability of their care needs. Then insist that everyone in the MDT meeting reads your document, or allows you to read from it. Additionally, where possible, get EVIDENCE in support of your views from the care records/medical records. Also, provide clear copies in support.
Consider professional representation.
There are several reasons why you may want to consider professional support at an MDT, and after the initial checklist stage. You may not have the time or inclination to get to grips fully with the 140 pages of National Framework on NHS Continuing Healthcare. This is the document all Clinical Commissioning Groups (CCGs) are obliged to refer to in their decision-making. Yet, they often fail to follow.
You may also not have time to get fully into all the case law. This places legal limits on the duties of CCGs and local authorities when it comes to establishing a primary health need and funding care. Equally, you may not be familiar with all of the complex medical jargon that can get thrown around by experts during proceedings.
Without that knowledge at your fingertips, it can be hard to take MDT members to task. This is especially true, if they were to ignore, underplay or misinterpret vital evidence. Financial considerations are often the elephant in the room at these meetings. Yet, they shouldn’t be. Ensuring there is a sound clinical and practical basis for every assertion by every “expert” can be a daunting, difficult and long-winded process.
Fortunately, it is what we do day in, day out here at Just Caring Legal. It is our speciality, and our knowledge and expertise can help your family access the funding they are entitled to. Additionally, we offer the support and advocacy to help you through what is often an incredibly stressful time.
If you would like more information on how we can help you achieve the best possible outcome from an MDT decision meeting, contact us today for a free consultation.