Further insights into lack of impartiality: flawed NHS Continuing Healthcare Independent Review Panels
We were recently contacted by Peter, who previously worked as Chair of an NHS Continuing Healthcare appeal panel.
(We’ve changed his name here.)
Peter told us about a new practice by his own CCG that raises even more concerns about the fairness of NHS Continuing Healthcare appeals.
He recently had to go through the NHS Continuing Healthcare funding assessment process personally on behalf of a relative. His relative was fully funded for a long time through Continuing Healthcare, without any problem, but at the last assessment the assessor said that his relative no longer qualified.
Peter advised the CCG that he intended to appeal, and requested an NHS Continuing Healthcare Independent Review Panel (IRP) hearing.
He then received a telephone call stating that the appeal would be held locally – and he was surprised when the original assessor attended and stated that she would be handling the appeal herself. It was hardly independent. Peter wondered if the CCG hoped this would stop the family proceeding further.
The assessor stated that she had reviewed the situation and had not altered her opinion about removing funding from Peter’s relative. She also advised that it was not worth taking things any further.
Peter wrote to the Chair of the CCG expressing his concern at this ‘IRP’ not being independent. Had he not known the proper appeal procedure, it’s possible that he and the family would have had to simply accept the decision.
He received an unhelpful response, but the family was subsequently invited to a new review. This was held at the CCG’s offices and was dealt with by the manager of the original assessor. The manager discussed the case and confirmed the original decision would stand, i.e. funding would be removed.
Again, Peter suspected the CCG hoped this would stop them going any further.
However, Peter informed the manager that the family was unhappy and would continue with the appeal. His relative needed full 24-hour care at home, and now her health had deteriorated further.
An appeal of the funding decision was arranged, but this was postponed several times. The reason given was that “there was not a Chair available”.
The family wanted answers to their questions about the lack of independence in all this. They were informed that the CCG had altered its procedures and, from now on, appeals would be dealt with by an in-house member of staff – as had happened with Peter’s relative.
Unfortunately, Peter’s relative died, and he decided not to take the appeal any further. However, it left him wondering how many other families have just accepted this supposed ‘new process’ without question.
It’s not unusual for a senior member of staff to initially review the funding situation – but it’s deeply concerning that it involved the same person who carried out the actual assessment because there was a complete lack of impartiality.
On account of his background, Peter is aware that CCGs do not like appeals, as these are both costly and take up much time. It would however be interesting to know how many families are coming up against the same problem when requesting an IRP and how widespread this ‘change in procedure’ might be.
Have you been in a similar situation? Did you actually get to an NHS Continuing Healthcare Independent Review Panels outside your local area – and was the Chair independent?
We’re interested to hear whether other families have also experienced such flawed NHS Continuing Healthcare Independent Review Panels. (Please avoid mentioning any specific names of CCGs or local areas.)