Many people needing an assessment for NHS Continuing Healthcare – or who are waiting for a Continuing Care appeal – are experiencing long delays in getting this done. It can be exasperating for families. And, in the meantime, their elderly relatives in care may be (wrongly) means tested and told to start paying care fees.
How long have you been waiting?
The health and social care authorities tend to put the onus on families to find out about care fees funding in the first place and many families are left in the dark about NHS Continuing Care funding. Then the authorities leave it up to families to chase proper assessments, pick up on maladministration in the assessment process and raise objections when care fees are imposed illegally. It causes a huge amount of anger and distress for families.
If you’ve lodged a retrospective claim for NHS Continuing Care with the NHS to reclaim care fees already paid, the chances are you’re still waiting to receive even an acknowledgement of that application. You may not have had any replies to your phone calls or letters. This lack of communication is unacceptable behaviour for any organisation, let alone one with responsibility for vulnerable people.
Keep chasing your claim with the relevant NHS Continuing Care Dept. Let them know you’re not going to go away and that you need to be kept informed of timescales for reviewing your claim. In our experience of the whole Continuing Care process, you often have to make a nuisance of yourself to get a response.
The Continuing Care Dept may say that they have a backlog of claims to deal with, but this is no excuse for not providing you with any information at all about when they’re likely to look at yours.
Current Continuing Care assessments
If you’re waiting for a Checklist assessment and you’re told by the Continuing Care Dept that it will take weeks or even months to get this done, this could well be an attempt to get you to start paying care fees.
The NHS may be short staffed, but a Checklist assessment can be carried out by any health or social care professional who understands the process, e.g. an informed care home manager, a social worker, a community psychiatric nurse, a district nurse, a GP (although many GPs are unaware of the process), or another health or social care practitioner who knows your relative’s health and care needs. It is a relatively short assessment and should certainly not take months to get done.
If you’re getting no response from the NHS itself, ask a health or social care professional directly to carry out the Checklist and send it to the NHS Continuing Care Dept local to your relative. Talk to the GP as well, and raise your concerns.
If you’re waiting for a full Continuing Care assessment (Decision Support Tool), and you’re getting no response, keep sending letters to the NHS Continuing Care Dept.
Many people also find it helpful to get the local MP involved too, and to copy in the MP on all correspondence. Find your local MP here.
The full assessment should take place – and a decision made about funding – within 28 days of the Checklist assessment.
Continuing Care assessments in hospital
If your relative is in hospital and you’re being told they’ll be assessed once they’ve left hospital, be cautious. Read these 5 things to check before your relative is discharged from hospital.
If your relative is likely to show significant improvement in the short-term, the NHS may provide short-term rehab or reablement care, and so may wait until your relative’s actual care needs are clearer before it does an assessment. However, if your relative’s condition is unlikely to improve in the short term, a Continuing Care assessment should be carried out before they are discharged.
Continuing Care appeals and review
If you’re challenging or appealing a decision about Continuing Care funding and you’d like a review – or if you’re waiting for an Independent Review at the Strategic Health Authority – there are specific timescales in which this should take place. Read more about Continuing Care review timescales.
Always remember, it is not correct for the NHS to expect people to pay for care while waiting for an assessment. If this were the case, it would give the NHS carte blanche to delay assessments indefinitely. For that reason, at Care To Be Different we often recommend that families dig their heels in and refuse to start paying care fees until the proper assessment process has been followed – to allow a proper decision to be reached about who is actually responsible for paying for care.
Any health or social care professional who tells you otherwise – or who simply says there’s “no point” doing an assessment because “you won’t qualify” – may be trying to get you to pay for care under false pretences.
How long have you been waiting for a Continuing Care assessment or review? Leave a comment below.