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CHC (Continuing Healthcare) support thread

Georgina63

Registered User
Aug 11, 2014
968
For those of you not aware, there is judicial review pending on CHC payments (it is being crowdfunded by the ex head of UK nuclear deterrent) who is claiming that £5bn of CHC payments have been refused unfairly. The reality is this matter is postcode lottery. The approach will vary depending on the CCG and area of the country.
Details can be found here
 

Lirene

Registered User
Sep 15, 2019
239
Thank you and there certainly needs to be, Hospital advised if I had lived in a different postcode there would have been no problem. Good luck to all involved. Prayers for everyone xx
 

Georgina63

Registered User
Aug 11, 2014
968
Thank you and there certainly needs to be, Hospital advised if I had lived in a different postcode there would have been no problem. Good luck to all involved. Prayers for everyone xx
That is dreadful and so completely wrong! But sadly we know this to be the case when the award rates differ so much across Clinical Commissioning groups with no credible explanation. Good luck with your appeal (I have had a local appeal and have IRP later this month). Are you getting help? https://caretobedifferent.co.uk/ is very helpful and there are support groups on Facebook if you are on that. All the best Gx
 

ancistrus

Registered User
Nov 15, 2020
16
Helli there,

I recently went through the CHC pricess for my mother and was not successful.
The meeting was done via mucrosoft teams and it only included me, the chc nurse and a trainee nurse.
At the end of the meeting I was told my mum would not qualify for chc. This was six weeks ago and I have received no written confirmation.

I would like to know from forum members if it is correct for the ccg to give a decision straight after the meeting, should they not go away and decide over the course of a few days?

Regards
 

Louise7

Registered User
Mar 25, 2016
2,583
Welcome to the forum @ancistrus Mum has had two CHC assessments and the first time we were told the outcome even before the assessment had taken place, the second time we were told straight after the meeting. I know that there's been various backlogs due to the covid situation but you should have received a decision notice by now so worth chasing this up. Unfortunately it can be very difficult to get CHC funding, although some members here have been successful.
 

Lone Wolf

Registered User
Sep 20, 2020
57
Unless the covid regulations allow for shortcut assessment procedures, the official guidance requires 2 different health professionals at the MDT, one should be a social care professional, and they should have good knowledge of your Mum's health conditions. The MDT should make a recommendation to the CCG, who then make the decision. Attached is a short form version of the official guidance, required to be followed.

PS: Was it a full assessment or just the checklist stage to assess whether to proceed to an MDT assessment? The procedure above refers to the full MDT assessment.
 

Attachments

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Louise7

Registered User
Mar 25, 2016
2,583
The MDT should make a recommendation to the CCG, who then make the decision.
Yes, although there's nothing to prevent the assessors telling you what their recommendation will be, and it's apparently rare for the CCG to disagree with the assessor's decision.
 

ancistrus

Registered User
Nov 15, 2020
16
the social worker was supposed to be involved but on the day of the assessment her technology failed apparently. I had a hard job even getting the checklist done as the social worker was adamant there was no point doing one. We got the district nurse involved to do the checklist and when she came she said my mum should be in a nursing home....
the social worker put in a plan where two carers visit four times a day, she reckons my mum would not need a nursing home as the district nurses can sort her bed sores and carers can address her personal care needs...
The district nurses currently visiting my mum say she should be in a nursing home yet social worker says otherwise and the ccg think my mum does not qualify for chc.
What a mess

I was wondering what happens if we put my mum in a nursing home without the socisl worker agreeing, can we still request nursing funding care? Also shoukd the chc assessment have considered funded nursing care as well as chc or would this be assessed in a separate process? No mention was made of mum not qualifying for chc but potentially qualifying for nursing funded care.
 

Jessbow

Registered User
Mar 1, 2013
3,125
West Hertfordshire
the social worker was supposed to be involved but on the day of the assessment her technology failed apparently. I had a hard job even getting the checklist done as the social worker was adamant there was no point doing one. We got the district nurse involved to do the checklist and when she came she said my mum should be in a nursing home....
the social worker put in a plan where two carers visit four times a day, she reckons my mum would not need a nursing home as the district nurses can sort her bed sores and carers can address her personal care needs...
The district nurses currently visiting my mum say she should be in a nursing home yet social worker says otherwise and the ccg think my mum does not qualify for chc.
What a mess

I was wondering what happens if we put my mum in a nursing home without the socisl worker agreeing, can we still request nursing funding care? Also shoukd the chc assessment have considered funded nursing care as well as chc or would this be assessed in a separate process? No mention was made of mum not qualifying for chc but potentially qualifying for nursing funded care.
The fact that anyone thinks someone should be in a nursing home, The NHS funding the placement is another thing entirely.

You can choose to put your mother into a nursing home if you have POA , if not she'd have to agree - there will be an financial assessment- her income and assets determine her contribution
 

LocalResident

Registered User
Jul 21, 2013
20
The fact that anyone thinks someone should be in a nursing home, The NHS funding the placement is another thing entirely.

You can choose to put your mother into a nursing home if you have POA , if not she'd have to agree - there will be an financial assessment- her income and assets determine her contribution
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To try and get a bit of clarity, (many issues); what was the outcome of the check list? Everyone is entitled to have the check list. Then the full CHC assessment must be organised by the social worker and the local NHS CCG.
Has the full CHC assessment been done? Have you received a copy, if so even if there is no entitlement, have you checked their DST document forensically [see one of my earlier posts]?
The nursing home and the (possible) nursing contribution are as I understand things separate matters.
 

ancistrus

Registered User
Nov 15, 2020
16
the checklist outcome was that there should be a full chc assessment.

the chc assessment went ahead without the social worker because the social worker was unable to use m teams on the day.

I was told at the end of the meeting that our application was not successful.
I am still waiting for a letter with the decision notice six weeks on.
 

LocalResident

Registered User
Jul 21, 2013
20
the checklist outcome was that there should be a full chc assessment.

the chc assessment went ahead without the social worker because the social worker was unable to use m teams on the day.

I was told at the end of the meeting that our application was not successful.
I am still waiting for a letter with the decision notice six weeks on.
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The decision document, which might be called a DST, usually needs to be requested. In Worcestershire, a copy is NOT automatically sent, only the decision i.e. not eligible etc.
It will then be up to you to perhaps submit an appeal. Beacon, (and the Alz. Soc.) can provide some free advice on making an appeal. It is my view that after you've received the DST you should go through it forensically, and if you find any errors, omissions, the need to clarify points, inaccuracies, etc. etc. you should make a SEPARATE formal complaint about the CONTENT of the document. Don't mix this up with the appeal which you might make. I saw a very poorly prepared DST, put bluntly, it was extremely shoddy! If your local CCG/NHS Trust fail to deal with a formal complaint, you can then involve the Ombudsman. Also keep your local Health Watch informed. It is hard work! Good luck.
 

Lone Wolf

Registered User
Sep 20, 2020
57
Why wasn't the meeting reconvened for when the social worker was able to join in? Possibly grounds for appeal, but I would recommend advice from the sources posted by LocalResident.

Agree with Jessbow, the first and most urgent priority, given the pressure sores, is whether mum should be in a nursing home, and the district nurse would be a better judge of that than the social worker. Pressure sores would require frequent repositioning and close monitoring. Would the social workers home care plan be enough?

Assuming mum is not self funding, could you ask the district nurse &/or the GP to speak to the social workers superior about a need for nursing home placement?
 

ancistrus

Registered User
Nov 15, 2020
16
hi money is not an issue we would self pay.
i agree about sores, d nurse had to come out urgently last week to sort bleeding elbow sore and gp had to prescribe antibiotics.
the care agency was supposed to come early morning and late evening plus twice during the remaining time but they they are often late in the morning and early in tne evening so my mother does not move for many hours.
the question i have can social services object to a care home placement even if one is self funding?
 

Hayley JS

Registered User
Feb 20, 2020
177
No SS can't object. If mum is self funding and you have LPA you can go ahead and sort a CH placement. I'm surprised the social worker hasn't already disappeared off the scene if they know you are self funding. Nor will this affect any claim for CHC. Best wishes.
 

Lone Wolf

Registered User
Sep 20, 2020
57
+=+=
To try and get a bit of clarity, (many issues); what was the outcome of the check list? Everyone is entitled to have the check list. Then the full CHC assessment must be organised by the social worker and the local NHS CCG.
Has the full CHC assessment been done? Have you received a copy, if so even if there is no entitlement, have you checked their DST document forensically [see one of my earlier posts]?
The nursing home and the (possible) nursing contribution are as I understand things separate matters.
Were you ultimately successful LocalResident?

My partner had a badly conducted fast track review in February this year. Complained twice to CCG, but both times they completely ignored the grounds of my complaint and gave fob-off replies. Now waiting for full MDT assessment. l am weighing up whether to extend the courtesy of informing them that I will be recording the meeting, and if so whether to do it at the meeting or in advance.
 

Amethyst59

Registered User
Jul 3, 2017
5,764
Kent
I hope this is not too off topic, briefly...my husband is in a care home, self funding, on end of life care. For a couple of months a wheelchair had been used to move him from bed to lounge, but, as his body has stiffened it proved too difficult to use. The care home arranged a physio assessment for a wheel chair that would support his head, and body, in a more comfortable position. It made matters worse in that I was not involved in the process because of the COVID restrictions.
The decision was made by the physio that he ‘was not eligible’ for such a chair. I assume if he had been deemed ‘eligible’ it would have opened the way for us to try and get CHC. In fact, had such a chair been thought helpful, we would have purchased, or hired, one if possible.
As it happens, he is now too ill to be moved from his bed at all. It just annoyed me that the decision looks as if it was made not in his best interests, but from a financial point of view.