+ Post a comment
Results 1 to 8 of 8
  1. #1

    CHC - continuing health care RANT

    Mum is at stage 5 to 6 diagnosed 8 weeks ago. As a new TP member, I have read ALL the really usefull leaflets on the main site and have further read TP postings back to front. I WOULD STRONGLY ADVICE ALL NEW MEMBERS TO DO THE SAME if time permits; what an eye opener.

    MY RANT........CHC. It seems almost impossible to get and when I have read some of your stories, alas, they have brought me to tears.

    The NHS and SOCIAL SERVICES etc seem to be run on form filling and assessments !

    PRAY..........WHY ?

    I have a really stupid solution to this utter waste of time and paper, why not allow our DOCTORS/GP's do the assessing. Call me stupid but generally they have known the person for at least 50 years. Whilst I acknowledge that they are not specialist in mental health, by the fact they have know US PERSONALLY FOR YEARS, doesn't that count for something ?

    To think I have paid all my taxes to be paid on paper fillers and assessors, I honestly think in a five minute conversation, my doctor could reach a very quick decision about CHC and furthermore, the best way forward for my mother.

    Please AGREE or DISAGREE, no offence will be taken either way.
    Thanks and rant over and the very best of luck to everyone trying to obtain CHC.

  2. #2
    Registered User
    Join Date
    Nov 2011
    Location
    Derbyshire
    Posts
    169
    Hi, I agree it is a very frustrating process with all the forms and waiting.

    In our case once the hospital had decided to plan for mum's discharge, we had to wait about 3 weeks for a meeting to be set up for the DST assessment. The meeting involved PCT nurse assessor, PCT mental health assessor, staff nurse, social worker and me. It was a long meeting 2-3 hours. I felt like I had been through the wringer after. The recommendation in our case was for continuous care funding. This goes off to a panel with lots of supporting documentation from the hospital. When the panel looked at it they said it needed to go to the mental health panel. It took about 3 weeks to get the decision and then the home had to assess her and agreed funding with the PCT - probably another 2 weeks.

    Everyone had said how hard it is to get continuous care funding so I didn't expect to get it. At the time of the assessment though, mum was really poorly which probably went in her favour. She scored severe for cognition and behaviour but also was high risk of falls, refuses her medication at times and has weight loss/swallowing issues and some incontinence. I have a friend whose mum is quite well apart from the cognition and behaviour and she used to get continuous care funding but this was withdrawn, despite the fact that she cannot be left and needs someone there round the clock. They seem to think that dementia is a social need but if someone cannot be left because are basically at risk of harm if they are left, then surely this counts as needing 'continuous care'.

    Since the assessment, mum has picked up quite well and is eating better. She has put a bit of weight back although is still under weight. She is mostly continent but only because she goes to the loo 2 - 4 times per hour (a bit of an obsession of hers). She has had a number of falls and keeps forgetting she can't walk safely and tries to get up almost constantly. She had fallen from her chair and out of bed despite crash mats, sensor pads etc. We are currently waiting to see if the PCT will fund the 18 hours 1:1 care the home say she needs (they are currently providing 10 hours and being paid for 8). I am going to chase the PCT tomorrow as since they went to see her over a week ago now, she has had at least 2 falls which would have been avoided if they had the 1:1 in place.

    Paying for 1:1 care is impossible without continuous care funding.

    With regards to your point about GPs assessing people, that may work in some cases but in mum's case, the GP sent her into hospital with a UTI and retention and thought the confusion was due to the infection. While in hospital, the confusion continued and she was diagnosed with vascular dementia. The GP would have had no idea of her state of health in October when the assessment was done as she hadn't seen her since August when the expectation was that she just needed fluids and antibiotics and she would be able to come home. The GP thought the loss of appetite was due to depression when it turned out she had a gastric stricture and so couldn't swallow. In our case, the hospital assessment was much more thorough and they had the logs and other paperwork to back everything up.
    Jane x
    Last edited by PurpleJay; 04-12-2011 at 09:56 PM.

  3. #3
    Registered User
    Join Date
    Aug 2011
    Posts
    183
    Am not sure I agree about the GP bit, well not with my MIL anyway.....its ok if the GP has known the patient for a long time, but that is not necessarily the norm these days - damn lucky to get one out!!

    CHC is a minefield run principally by financially driven jobs worths with flowcharts. It is also a postcode lottery. When my MIL was assessed it was entirely evident that goal posts were being pushed to fit their criteria to turn her down. However, initially it seemed pretty certain she would get it. Then with intensive care in hospital (for the first time for months), she improved so they turned her down. It isn't rocket science, she improved because of the care she was being given....

    She is totally immobile, has bed sores - one infected, UTI's (she has a catheter), doubly incontinent. When she wasn't eating they maintained it was because she had dementia, when it came to the form they said it had not been diagnosed!!! Actually she wasn't eating because of an untreated UTI which they released her from hospital with!!

    It took 4 weeks for the assessment results, a further two to get a copy of the damned thing (which they didn't want to provide) and when we read it we actually felt they were referring to the wrong patient it was so much of a fairy tale!!

    Then of course you have the scenario that they withdraw CHC because of the improvement which has only happened, as PurpleJay says because of the level of care provided. The patient without it runs the risk of deteriorating - so you have a ping pong ball scenario.

    Whilst they allow the funders to make the decisions, CHC will continue to be a farce.
    I find the whole system unbelievably crass.

    In essence, the government encourages you to save up for your old age and give you tax incentives on your pension whilst working........they do that so you will pay for your care when you need it and they don't have to.....in fact any money you save or put into a pension is actually potentially the Government's and not yours at all....

    THEN when you retire and you get your pension they tax it (unearned income) even if you are having to pay for care which they won't provide .......

    Then if you are unfortunate enough to die and leave some of your savings to your children (which you would liked to have done anyway had this damn welfare state actually worked), if it is over a limit (ridiculously low if a house is involved), then they tax it again.....

    I firmly believe that if you save and have a pension in place and have no choice but to use it to pay for your care, you should not under any circumstances get taxed on that pension.........it is a double whammy.

    Any person with medical issues whether that is "social" (daft word really) like dementia or purely medical, should have care paid for by the state up to a certain level. If you want a more upmarket home then you can choose to top up - but that should be your choice.

    The State expects us to plan for the future but it is quite clear they haven't and we are the ones suffering because of it, and that situation will get worse...... whilst this government (and its forebears) can afford to send money abroad, pay scroungers and house people who have no right to be here, they have a financial duty of care to our elderly and infirm.

  4. #4
    Registered User
    Join Date
    Mar 2009
    Location
    Welwyn Garden City
    Posts
    392
    Marion,

    You mention an improvement because of the care being given. This is effectively a health need that is being well managed, but the need is still there none the less. It shouldn't be downgraded because of how well it is being managed and the only way they can say it is no longer a need is if they have managed to cure the need.

  5. #5
    Registered User
    Join Date
    Mar 2011
    Location
    Southern England
    Posts
    13,746
    Blog Entries
    1
    I won't reiterate all my husband's all my husband's health problems both mental and physical - too many to be listed but suffice it to say he cannot walk, talk coherently, do anything at all for himself including eating, is incontinent, confused,etc. etc. When the application was made for CHC funding, he also had gangrene on his remainng foot and pressure sores on his back.

    After it was refused, a sister in the the hospital he was then in, said that CHC funding was not given for nursing needs - no matter how severe - only for specialist nursing care! That can be interpreted any way the PCT chooses - and it will usually be to the detriment of the patient.

    It is a lottery anf the sooner a definitive criteria is made, common to all, wherever they live, the better. A nurse in a Nursing home I visited said that to be bale to get CHC funding nowadays, you have to be at the terminal stage- in our area anyway. This doesn't seem to apply everywhere judging from what i have read on TP.

    I hope you don't mind my sharing your rant Hollycat. x

  6. #6
    Registered User
    Join Date
    Mar 2009
    Location
    Welwyn Garden City
    Posts
    392
    Hello Saffie,

    The nursing sister got it so wrong. Its not about nursing needs, it is all about a persons health needs. Nowhere does it talk about a person needing specialist nursing. Barbara Pointon eventually won her case for continuing care and she was nursing her husband. She was not a trained nurse. It's nothing to do with who provides the care but the level of needs the person has.

    That someone with as many needs as your husband was turned down is an utter disgrace and suggests manipulation of the national framework by those who did the assessment.
    Last edited by Bob S; 05-12-2011 at 12:32 PM.

  7. #7
    Registered User
    Join Date
    Mar 2011
    Location
    Southern England
    Posts
    13,746
    Blog Entries
    1
    Thanks Bob - I think so too, but at the time I had so much going on what with pressure from community hospital for husband to move to a nursing home, applying for Deputyship to enable me to sell a holiday chalet etc. that, although I did write to the PCT asking for clarification and a sight of the tool used,I didn't have the energy to take it further.

    Anyway, the PCT wrote that I was able to make a complaint if I believed the process used was flawed - however, "such a compliant will look at the process used, not the decision itself". The process was fine - I agreed with every word the nurse who had completed the assessment, wrote. what I did not agree with was their downgrading of practically everything written.

  8. #8
    That's appalling Saffie

    Dad just had his 3rd assessment, I got the letter with the accompanying measurement tool they use and he is still getting CHC. He has all the same things you mention bar the pressure sores etc. Why did Dad get it in NW England and you didn't.. it beggars belief

    I had to have a massive row with the District Nurse when I requested spare padded dressings to use on a suspect pressure sore before it actually breaks. I'd used the last one that week and managed to stop it happening...She told me they were not allowed to prescribe unless there is a pressure sore present... So I rang the head of DN's and complained, he sent some over. Perseverence and the use of the word 'prevention' seemed to do the trick. Are these rules completely bonkers or what? The risk of pressure sores is not going to go away anytime soon

 

 

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts