Many families feel exasperated when they receive a letter saying NHS Continuing Healthcare denied.
You may have been through the local-level NHS Continuing Healthcare assessment process and been told that this funding is being refused. You may be wondering what your next step should be.
If you have grounds to believe that the funding decision is wrong, you can appeal. But what should you do first?
Write straight back to the Continuing Healthcare team and state that you disagree with the outcome. State also that you will be appealing, that you would like information on the appeals process and that you will be submitting detailed reasoning for your appeal in due course.
Then, you need to do the following…
2 things to do when NHS Continuing Healthcare denied
- The process: Write down all the things that have been done incorrectly/badly in the Continuing Healthcare assessment process – right from the start. This could also include any intimidation, obstruction or delay you feel you’ve encountered, untruths you believe you’ve been told by assessors, failures on the part of the NHS to put together a full multidisciplinary team at the full assessment, failure to follow the National Framework guidelines, unacceptable behaviour by assessors, etc.
- The eligibility criteria: Write down all the inaccuracies, misstatements of fact, misleading comments and omissions in the Checklist and/or DST report(s). Also include reference to evidence that has been ignored. Also, be sure to set out the scores you believe your relative should have been given in the assessment, and show how their needs match the eligibility criteria for NHS Continuing Healthcare.
The NHS may offer you a Local Dispute Resolution Meeting initially – but reports from families show that this is usually just an opportunity for NHS assessors to try to persuade you they’re right. You may need to argue instead for a repeat assessment or apply for an Independent Review Panel hearing at regional level.