NHS Continuing Healthcare Funding Put On Hold

NHS Continuing Healthcare Funding Put On Hold

With the outbreak of coronavirus it is not surprising that assessments and appeals for NHS Continuing Healthcare Funding are being put on hold, and those Clinical Commissioning Groups which are still operating in this area are likely to stop shortly.

The impact is already having a dramatic effect throughout the country.

Those with family and friends currently in hospital awaiting discharge to a care facility are at risk of catching Covid–19.

Care homes awaiting the transfer of new residents will equally be anxious to ensure that they do not import the virus with them.

Most care homes need an influx of new residents to make it commercially viable to remain open.

Some care homes have already closed their doors and will not admit new residents or allow visitors to enter in case of infection.

In the event of an imminent escalation of preventative measures and an enforced lockdown, nurses, carers and auxiliary staff in care homes may also face restricted access to their patients. Just as carers employed to look after patients living at home may be forced to reduce their support, leaving the most vulnerable and needy in society isolated and at risk.

The elderly, frail and those with serious underlying medical conditions at risk with chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis, chronic heart failure, chronic kidney disease, chronic liver disease (such as hepatitis), diabetes, chronic neurological conditions such as Parkinson’s disease, motor neurone disease, multiple sclerosis or cerebral palsy, or generally have a weakened immune system, are all considered at highest risk.

In the majority of cases, assessments for NHS Continuing Healthcare Funding start with an initial Checklist screening tool to determine whether the individual should move forward onto a full assessment carried out by a Multi-Disciplinary Team. However, if the individual cannot even be assessed for the Checklist due to the risk of the virus spreading, then many assessments will be cancelled or deferred. The Government cannot say when it will be safe to engage in social interaction again, but the current thinking is that it is going to be many months, rather than weeks. Some commentators consider it could be another 12 to 18 months yet, whilst the vulnerable, and those who have or may be in the throes of contracting coronavirus, need to remain in isolation.

Similarly, if Multi-Disciplinary Team meetings (MDT) cannot proceed either, then individuals will not know whether they are eligible for NHS Continuing Healthcare Funding or not. In the meantime, they may be required to fund their care out of private means and use up hard-earned savings. These inevitable delays will cause severe financial hardship for families as they try to find sufficient funds to pay for their relative’s ongoing care.

In terms of Local Resolution Panel appeals following the outcome of a negative MDT meeting, or further appeal to NHS England, these too will be cancelled and adjourned, causing a dramatic financial knock-on effect for those have been forced to fund their relative’s care pending the outcome of an appeal. Who knows when the hearings will be reinstated? Those at the back of the queue could face a very lengthy wait and years of anxiety, before their appeal is heard and the outcome decided.

Most CCGs are already unable to adhere to the timeframes for conducting an MDT. Appeals to a Local Resolution Panel and NHS England have generally been taking considerably longer to get a Panel hearing date, and then there are generally inordinate delays in the outcome decision being communicated to families. Now that MDTs and appeal panels are being cancelled throughout the country, families will have to dig even deeper to find additional funds to pay for their relative’s care during the intervening period.  We do not know how care homes will manage the situation or how sympathetic they will be, given that they, too, have fixed overheads and staff wages to pay in order to keep their residents well–looked after in a safe and caring environment.

We certainly are currently living in unprecedented and challenging times.

The Government’s daily warnings clearly mean staying indoors, avoiding public and social gatherings, and staying clear social contact. The inevitable impact will mean that individuals going through the assessment or appeal process, and who may be eligible for CHC funding, will have to wait until the CCG’s ‘doors’ reopen again. The CHC assessment and appeal process as set out in the National Framework for NHS Continuing Healthcare Funding and NHS–funded Nursing Care already contains flaws and, unfortunately, this unprecedented and unforeseen crisis will only fuel the public’s anxiety. Read our recent blog: Is the National Framework Still Working Effectively?

Not only will people be refused entry into the care home to check on whether their spouse, relative or friend are getting adequate care and attention and that all their daily needs are being met, but they may be saddled with the additional worry of how they are going to continue funding their care if the whole NHS CHC assessment process grinds to a rapidly approaching halt. Given the current state of uncertainty and stretched NHS resources, some with an existing CHC package of care will undoubtedly benefit from having their annual reviews postponed and avoid the potential risk that funding could be withdrawn. But, sadly for others, it could mean that they are stuck with a current CHC care package that is inadequate to meet their increasing healthcare needs. We shall have to wait and see how CCGs manage the crisis.

We do not know at present when the CCGs will be fully open for business again, but in the meantime, there are things that you can be doing in these difficult times:

  1. Start to prepare your thoughts on paper for the MDT.
  2. Collate your evidence and prepare your written submissions for an appeal.
  3. Read our helpful guide “How To Get The NHS To Pay For Care” – available as an ebook/PDF to download or paperback.
  4. Read around the subject and look at the many blogs written on the Care To Be Different. Browse through our website or use the search box if you are looking for a specific topic or issue.
  5. Visit our Facebook page and read what others have said about their CHC experiences and learn from their issues.
  6. Seek available guidance if you need it – email your enquiry to us at enquiries@caretobedifferent.co.uk
  7. If you can’t find what you’re looking for on our website, use our Advice Helpline Service for more detailed and lengthier queries, and book a telephone appointment to speak directly to one of our specialist nurse advisors.
  8. If you need professional advice visit our one-to-one page.

19 Comments

  1. Irene 6 months ago

    Hi we were due to attend a CHC appeal meeting on 9th April for my mum, which has just been cancelled, probably for several months. Mum will run out of money in 6 weeks, and we also currently fund a 24 hour 121 as she falls constantly without one, so if no-one is willing to take over the costs the 24 care will stop. So worried for mum’s health and how this will work out – will social services pick up the tab for basic costs in time, will anyone fund a 121. Has anyone had any success in asking CCG to overturn a negative outcome on a temporary basis until covid19 ends, in order to safeguard their relative and prevent severe injury?

    • Michelle wetherall 5 months ago

      Hi Irene,
      My understanding of the current situation, is that all funding be it social or NHS is to carry on and then it will be clawed back after Covid. Whilst that is a relief to know that funding will carry on during the crisis, it’s going to be a lot more complicated and difficult when the NHS/SS start to reclaim the funding. It’s a extremely worrying time for everyone, not least those who have loved ones in care homes. My father died in 2018, so I am spared the added worry of having him in lockdown in a nursing home. All I can offer is my best wishes to everyone in this unenviable position but urge them to keep records/invoices/statements and evidence updated during this period. There is nothing stopping you from registering appeals and complaints with a footnote to say that you will follow up at a later date with a full submission.

  2. C Evans 6 months ago

    My father’s Parkinson’s has unfortunately taken a turn for the worse at exactly the wrong time. He should have had a CHC assessment last week but this has now been put on hold. I have seen suggestions that funding should be available anyway, though the CHC process has been stopped but I don’t know where to start! Any ideas?

    Thank you

    And if you haven’t tracked down the Hospital Discharge Service Requirement yet, it’s here:
    https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/covid-19-discharge-guidance-hmg-format-v4-18.pdf

    • Michelle wetherall 6 months ago

      Hello C.E.Evans,
      I can only sympathize with you & everyone who is looking after elderly relatives and navigating CHC.
      I can not see why assessments can not take place through digital/social media means unless of course those NHS staff administering CHC have been required to work elsewhere in the NHS to help administrative duties involving COVID 19 and staff are genuinely deployed elsewhere.
      Then there is the worry of discharging patients to care homes/nursing homes when they are refusing to take on new residents for the fear of transmitting the disease.
      A horrible time for everyone. Stay safe and well.

  3. Ann Marie 6 months ago

    Thats interesting re hospital discharge my relatives money runs out soon chc have so far refused funding care homes will not be admitting how can they be cared for at home without funds ? Write to MPs health and social care ministers and anyone else ie age uk alzeheimers assoc ,parkinsons assoc ,etc

  4. Lynn 6 months ago

    Advice please. I’ve been battling for funding for my mum for a while. I’ve had a complaint running since mid Jan and am now just getting monthly emails saying “sorry we haven’t been able to respond to your complaint yet the CHC are still investigating. My mum died yesterday and I’m wondering in what way (if any) that changes anything. The only thing it definitely means is that I don’t have to hold back at all now. I was previously concerned that me being a pain was annoying my mums care home manager and employees so I had to work had to be clear it was the CHC team that didn’t follow the national framework. A definite silver lining to mum now being completely free of these horrible battles.

    • Michelle Wetherall 6 months ago

      Hi Lynn,
      My sincere condolences on the loss of your mum. I feel for you at this awful time. The loss of a loved one at anytime is hard to bear, but even more so in these incredibly difficult times.
      My advice is that “Nothing Changes!”. Be persistent with whatever stage you are at with CHC. You don’t say whether you are in the process of appeal? Or are you making a complaint?
      Don’t worry at all about being “a pain!” You have every right to expect a transparent and impartial service from your CCG/CHC. I was known as the “habitual complainer” at my late father’s nursing home. My answer to this, was “Well if you did the job properly, then there would be no need to complain”. You will find that many relatives are scared to complain, because they fear that their loved one will be at risk or asked to leave. Again, if folks are not prepared to voice their concerns/complaints, then how on earth are homes or indeed the process, going to improve.
      Good luck with it and remember there are lots of people on here who are very knowledgeable about the CHC process and the NF and offer excellent advice.

  5. Jeanette Andrews 6 months ago

    Can’t seem to put link on unfortunately tried to screen shot and don’t know how to put that on here either but if you Google
    COVID-19 Hospital Discharge Service Requirements.
    It should bring up an HM Government and NHS document that was published on 19th March 2020. Hope this helps

  6. Susan M Beachell 6 months ago

    Chc is a joke I think they disregard anyone who’s a self funder in care they know who they are beforehand.. I know my mum had health issues which morphine came into play as well as no speech or mobility in pain ..but no they classed her as not needing nursing care bit placed her in a nursing home… She lasted 4 weeks unfortunately .. I really think there’s an agenda there and yes video conference way to go.

  7. Andrea Long 6 months ago

    My mum was discharged from hospital into a care home pending a Social Services assessment. To cut a long story short it was decided she needed to stay in the care home. When she was admitted into hospital the first thing I was asked, driving up to the hospital to see her, was whether my mum had enough money to be self-funding. I was repeatedly asked this once I was at the hospital. I’ve since found out this was unlawful and nobody mentioned assessing her for a Primary Health Care Need, a process I have had to instigate myself. We have since completed the Checklist and the MDT was meant to be this month. I was told that mum would be self-funding from 17 December. Mum was discharged into a care home, Social Services deemed she was not safe at home and would not attempt another return home because of the risks to mum and others. I live some distance away and am the only person mum has. Mum hasn’t paid anything yet. If Jeanette Andrews is correct, would that mean that my mum should be funded until the CHC assessment takes place?

  8. mary 6 months ago

    My mums money is about to run out.
    What do I do as we are in the middle of trying to get medical records etc to prepare for an appeal?
    We live a few hundred miles from her. I am so frightened for her wellbeing.

    • Care to be Different 6 months ago

      Hi Mary – it looks like all appeals will be on hold for some time – you will need to check with your CCG. If you would like some help with the appeal or any other aspect of the funding process please do get in touch with us via our phone line 0161 979 0430 Kind regards

  9. Sam 6 months ago

    Having attended these meetings there is no reason they cannot hold the meeting virtually through video conferencing. Most people have access to the Internet either on their phone and there are multiple platforms that support . Also professionals can easily get the evidence they need by looking at emails of care plans, speaking to care staff and relatives over the phone. This would also streamline the process. The only exception should be if there is a greater need for health staff to be attending to people with Coronavirus i. E. A resource issue rather than an inability to have face to face meetings.

    • Steve Moxon 6 months ago

      The issue surely is the necessarily face-to-face assessment of the patient. There is no way assessment can be made without properly meeting and interacting with the patient. This hardly can be done via video conferencing.
      The focus for CCGs now anyway is all on COVID-19, and not on financial concerns as the NHS literally has a blank cheque for the duration of COVID-19 measures.

      • Lorraine Groves 5 months ago

        Unfortunately this is not the case for us; having been told that my fathers full assessment (scheduled for 25-Mar) was postponed I had a call today from someone at CHC who I’ve previously not had any contact with telling me they’ve scheduled a telephone assessment for a weeks time! I’m livid! It’s insufficient notice and we have not been able to visit my father since lockdown. I have requested the rationale for this and await a call (at the time they’d originally scheduled the tel assessment). I will be pushing back hard on this particularly as my fathers mental health is being very tried at the moment having been in hospital since Oct-19 and then discharged direct to a NH early Mar-20.

        • Irene 5 months ago

          Was your father discharged from hospital before 19 March? if 19th onwards, he should be awarded chc without assessment, funded by the government. good luck to you anyway x

          The info I found states that “as part of the emergency legislation – anyone discharged from hospital with a new or enhanced care package on or after the 19 March 2020 will have their care automatically funded by the state during the emergency period. You will not have to pay this money back.”

          I think yes those already with CHC will retain it, as no re-assessments can take place, it’s just those of us caught in the middle of initial appeal who don’t yet have CHC who will lose out. So worried as mum will run out of funds in just a few weeks and don’t know what will happen then, such a bad time to lose funding and 121 carers for mum, when I can’t visit to help re-assure her.

  10. Steve Moxon 6 months ago

    Well at least it means that CHC reviews of those already in receipt of full funding (with the possibly of funding being rescinded): these too surely will be suspended on the same grounds of the infection risk in necessarily face-to-face assessment.
    Every cloud …. or every coronavirus has a benign spike somewhere in its crown, you might say.
    As regards relatives’ access, the care home where my mum resides has notices on the front door advising to cut visits to a minimum, but I’m still encouraged to go up twice weekly to assist in feeding at main meal time, which I have done for a long time now, not least to keep full tabs on my mum’s care and her condition, comfort, etc. As I’m effectively self-isolating myself, then I don’t pose much of an infection risk, but I would guess a complete ‘lockdown’ is not far away which will prevent even those in self-isolation from visiting.
    [There does seem to be an over-reaction here, given that an infection symptomatically and transmission-wise identical to that of COVID-19 has been in my locale since at least last October.]

  11. Jeanette Andrews 6 months ago

    The Government have issued new legislation COVID-19 Hospital Discharge Service Requirements in the summary the government has agreed the NHS will fully fund the cost of new or extended out of hospital health and social care support packages with CHC assessments put on hold .

    • James Finucane 6 months ago

      Do you have a link to this info Jeanette?

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