5 tips from a successful NHS Continuing Healthcare case

5 tips from a successful NHS Continuing Healthcare case

5 tips from a successful NHS Continuing Healthcare caseFollow these tips during the Continuing Healthcare assessment process

We were recently contacted by Mary.

Mary had followed the information and advice on our website and had been able to secure NHS Continuing Healthcare for her husband when he went from hospital into a nursing home.

Her husband had sadly now died, but Mary wanted to share these tips from her own successful NHS Continuing Healthcare case. We’ve also added some additional links to help you:

5 tips from a successful NHS Continuing Healthcare case

Tip no. 1: “Keep a diary, especially as hospital records are not that brilliant. Your word can still be used as evidence. Even small things count.”

Tip no. 2: “Research, research and research again. Read the guidelines. Find out about the eligibility criteria and Primary Health Needs, and show how your relative’s care needs match the care domains and the four characteristics of need: Nature, Intensity, Complexity and Unpredictability.” See the National Framework pages 15-16

Tip no. 3: “The Coughlan Case is important. Remember there is a limit to what care the local authority can lawfully provide. This is why it’s vital that a social worker is present at a Continuing Healthcare assessment.”

Tip no. 4: “Before the Multidisciplinary Team meeting (the full assessment for NHS Continuing Healthcare), fill in all the scores in the care domains in the Decision Support Tool yourself first – and be prepared to argue for them.”

Tip no. 5: “Don’t be afraid to put your views to the assessor, and make sure you can back up what you’re saying. Yes it’s hard work – but it can be worth it.”

If you’re researching the guidelines in advance of an NHS Continuing Healthcare assessment, and you need to quote page and paragraph references to the assessors, this link will help you:

How to find the right page reference in the various NHS guidelines and documents

9 Comments

  1. Gary Horne 2 weeks ago

    My brother and I are currently navigating the process, on behalf of our mother who has Alzheimer’s, and to our surprise the hospital Multidisciplinary Team (MDT) recommended Continuing Healthcare with a very strongly evidenced Decision Support Tool report. However, the CCG has refused to accept it because it was done in hospital and not the community and because the hospital wouldn’t reconvene to discuss an Older Persons Mental Health team report, submitted after the MDT, despite the mental health team and the MDT saying this didn’t alter their recommendation. Despite this happening four weeks ago, the CCG have only just spoken to us via phone after we rang them but still not provided in writing their decision and the reasons for it. Has anyone had a similar experience? We are starting an appeal.

  2. Pearl Baker 2 weeks ago

    I applied for Continuing Healthcare (CHC) for the second time, the first was dismissed as he moved into another county. I applied again when in Hospital, only to be told, he will not qualify? I explained to the Dr it was not his decision, he passed the Checklist 17th January 2017 and was informed it would continue to the next stage when placed in a Nursing Home, it took months and finally approved in July of this year, he died in Hospital on the 27th July 2017. He died aged 99 with a fracture to his Hip in Hospital.

    I attended the meeting with a CCG Assessor and Local Authority (LA) CHC Specialist, where I discovered the LA recommended approval, but not the CCG Assessor (conflict of interest), however it was approved.

    It is important you keep a daily diary, learn all about the Domains.

    My father-in-laws Care is now part of a CQC Investigation.

    My father -in-law was to be discharged from a General Hospital against our wishes unable to speak, the subsequent meeting said he was well enough to be discharged. The Care Home Manager said she would not speak to me, as I was a Court of Protection Deputy for Property and Finance not Health, as a Relevant Persons Representative (RPR) under Deprivation of Liberty Safeguard (DoLS) you are there to offer Protection, this was completely ignored, he died within hours of the CHC and Hospital decision to return him back to the Nursing Home.

    Importance of keeping a daily diary, learn all you can about CHC domains, and understand what a RPR means for someone placed under DoLS

  3. Sonia 2 weeks ago

    My son is 45 with a history of Hodgkin’s disease, perforated ulcer, heart attack, query stroke etc. he is in hospital misdiagnosed with mental health problems. His legs are swollen (oedema) he cannot walk. He will need 24/7 care as he has been discharged from a section after 4 days. He is still in hospital, scans ordered etc. I am disabled, what do I do. Any advice please?

  4. Rosemary Bock 2 weeks ago

    Some of the text in this email isn’t showing. Is it perhaps white text on a white background? E.g. Tip 3 appears as ‘remember there is a …’ and ‘This is why it is…’ Thanks, Rosemary

    • Author
      Angela Sherman 2 weeks ago

      Thanks Rosemary. It looks as though you’re not seeing the links. Can you let us know which internet browser you’re using?

  5. Sue Smith 2 weeks ago

    My husband has now had 2 Continuing Healthcare (CHC) assessments. Both resulted in the Multidisciplinary Team (MDT) recommending he should get CHC funding as he had a Primary Healthcare need. Both were turned down by the local CCG. I am already appealing the first decision and am about to appeal the 2nd. Why do they hold MDT meetings to fill out the Decision Support Tool (DST) and then ignore the recommendation made by those professionals? I understood that the Framework Document says that the CCG should return the DST to the MDT for further work if they disagree with the weightings given. This was not done in my husbands case.
    I spend 24 hours a day caring for my husband, who I love very much, and I do have the help of Carers. However, it is exhausting both physically and mentally and any ‘free’ time I have I usually spend sleeping. I fully intend to fight on for the funding he deserves but I am finding it very difficult. Exactly what the CCG are hoping for I suppose.

  6. Agatha B 2 weeks ago

    I can wholeheartedly agree with the above tips. I have just secured Continuing Healthcare (CHC) funding for my Mum and it has been almost a 24/7 battle. I kept a full diary of daily events and for how long they lasted (you will need this to show the “intensity”). I researched and read everything I could and printed out important parts. I had 4 meetings with the assessors in the end and was disappointed to find out that I knew more than they did! They would tell me something and I would have to correct them, showing them part of their own guidelines, the NHS Framework or other guidance I had. They kept saying “Oh”. Eventually when they visited me they would make the comment “well you are the expert in CHC funding”! Eventually, the CCG panel raised two domain markings and the assessors raised a further two and we secured the funding. Having done so much research into this area, I now truly believe that the majority of people in care or nursing homes should also qualify for CHC funding. Sadly, some people have no one to help them do the work required for the assessments and, as I found, assessors just are not fully conversant with their own guidelines or the law, no wonder people do not get a fair assessment. Websites like this, and Angela’s book are a godsend and without them I might not have been able to secure funding for Mum. It took me over 3 weeks of constantly researching the web for information and tips. It is very, very hard work, and I can see how some people would give up, I felt like that myself many times but battled on for what I felt my Mum deserved. For anyone going through this process, follow the tips above. The diary of daily and nightly events and needs and the time they lasted what was what helped the most in our case. It gave a very clear picture of Mum’s needs, how they were managed (or not), and how long they lasted. And, lastly be prepared to work long and hard.

    • Author
      Angela Sherman 2 weeks ago

      Thanks for your very kind words about the book and website, Agatha.

Leave a reply

Your email address will not be published. Required fields are marked *

*

2100 characters max. All comments are moderated in line with our Acceptable Use Policy and our Terms of Website Use.