The Coughlan case and Grogan case – and NHS Continuing Healthcare
Many families have challenged the NHS on decisions to deny NHS Continuing Healthcare funding to their elderly relatives.
Successful outcomes are sometimes reported in the media. However, there are also many hundreds of families who are still battling to secure care funding, and many more who are continually refused.
There are two particularly well-known legal cases that have served as test cases for NHS Continuing Healthcare and you may find it helpful to read more about them here:
The Coughlan case
One case involved Pamela Coughlan, who successfully challenged North & East Devon Health Authority in 1999 after care funding was taken away from her.
The Grogan case
The other case was Maureen Grogan, who successfully challenged Bexley NHS Trust in 2006 about their decision not to provide her with Funded Nursing Care.
Read more about the Coughlan and Grogan cases.
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Is the case of Mrs N relevant to CHC funding. My mother had depression, several severe strokes and is now unable to communicate, peg fed, bed bound with contractures. Her recent DST showed 1 severe in cognition, but I was told that despite pre existing depression treated with anti depressants that she had to have NO Needs for psychological/emotional because she had no cognition.
She has several high and moderate needs as well.
I believe her needs are greater than Miss Coughlan’s and that funding should have been granted. Can you tell me if I can find some firm evidence in law that will back this up. Also at no time was a social worker consulted about the decision. The MDT does not appear to have happened and the day is signed by the RGN CHC assessor on 1 day and an RMN CHC assessor the following day. Does this constitute evidence of a MDT meeting??
Hi Sara – why not speak to http://www.farleydwek.com 0161 272 5222 Kind regards
I am going to panel to appeal the retrospective decision regarding my aunt. Payment was agreed for the last 7 months of her life. But the parameters within the domains remained constant from admission to the nursing home. The social service assessment on hospital discharge stated she needed 24 hr nursing care. It was impossible to assess those domains as priority as she was unable to move, talk and was deemed to having no capacity. The assessor only knew the last 7 months leading up to her death because the claim is retrospective. Following a dense CVA she was palliative on admission to the nursing home and there was no improvement or deterioration in her condition because her needs were met. This predication could not have been made had a CHC assessment been undertaken initially. Her nursing needs far outweighed those identified in the Coughlan case. Is Coughlan still the prima facie case or have there been any others that have taken precedent?
The Coughlan case is just as valid today as it was when Pamela Coughlan won her case at the Court of Appeal. The principles of the Grogan case are still absolutely relevant today, too. Take a look at the National Framework for NHS Continuing Healthcare – the Annexes at the end relating to these two cases: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213137/National-Framework-for-NHS-CHC-NHS-FNC-Nov-2012.pdf