In NHS Continuing Healthcare disputes, make sure assessors record your concerns in writing
NHS Continuing Healthcare disputes are common, and they can occur at any stage during the Continuing Healthcare assessment process.
Many disputes arise during the multidisciplinary team (MDT) meeting. This is the full assessment – where the assessors complete a Decision Support Tool (DST) form and then make their funding recommendation. Where there is disagreement about this recommendation, a local dispute resolution meeting may follow.
You may have verbally expressed concerns during the MDT assessment meeting and also at the end when you hear the recommendation. But how can you make sure those concerns are noted?
There’s a paragraph in the National Framework guidelines (the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care) that can help you:
National Framework page 95, paragraph 70.4:
“Where an individual and/or their representative expresses concern about any aspect of the MDT or DST process, the CCG coordinator should discuss this matter with them and seek to resolve their concerns. Where the concerns remain unresolved, these should be noted within the DST so that they can be brought to the attention of the CCG making the final decision.”
So, if you have concerns about anything at the MDT meeting make sure they get written down – very clearly – in the DST. Also, given that your concerns must at some point be noted, don’t wait until a local dispute resolution meeting for this to happen; instead, get it done at the MDT assessment:
- Before the MDT meeting ends, make sure you ask the lead assessor to include all your concerns – in writing – in the DST. (Better still, make sure the assessor does this throughout the meeting.)
- Refuse to leave the meeting until this is done.
- Ask for an immediate copy of the DST for your own records. (If the assessment is taking place in a care home or NHS office, there may be a photocopier nearby.)
As mentioned just now, where you disagree with the funding recommendation, there may subsequently be a dispute resolution meeting (held at local level) at some point after the MDT meeting. Your concerns should be fully addressed at that meeting. Take a look also at how the above paragraph from the National Framework ends. It says that your concerns should be:
“…brought to the attention of the CCG making the final decision”.
In other words, it is not only at the MDT assessment meeting that your concerns should be written down, and it is not only at a local dispute resolution meeting that your concerns should be addressed, but your concerns must also be addressed by the actual CCG decision making panel.
If your concerns have been properly recorded – in writing – in the DST, they should (in theory at least) automatically be seen by the CCG.
One final tip:
When asking the lead assessor in the MDT meeting to write your concerns in the DST, it’s also worth asking that person to add a note that you expect the CCG itself to fully address your concerns – in writing – in the letter that delivers the CCGs final funding decision.