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CHC (Continuing Healthcare) support thread

Andy54

Registered User
Sep 24, 2020
162
0
Thank you Andy54. Although each of these individuals had considerable input to the live meeting do you know whether they were all asked to mark the 12 domains of the DST as to the level of needs from low to priority that they considered your wife had ?

If so did you see how each of theses professionals along with the CCG assessor marked the checklist and consequently how the MDT as a whole came up with their final decision of the level of needs in each of the domains ?

Thanks again, very much appeciated.
Yes, each category was discussed fully and each gave their scoring. They were all generally in agreement but I did get the impression that there had been prior discussion between some of the professionals involved before the meeting. At the end of the meeting the assessor indicated that although it was not a guarantee, she would be recommending approval for funding. The whole process of applying for CHC funding was instigated by social services after my wife moved into care (she was initially part funded by local authority),
 
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Andy54

Registered User
Sep 24, 2020
162
0
Thank you Andy54. Although each of these individuals had considerable input to the live meeting do you know whether they were all asked to mark the 12 domains of the DST as to the level of needs from low to priority that they considered your wife had ?

If so did you see how each of theses professionals along with the CCG assessor marked the checklist and consequently how the MDT as a whole came up with their final decision of the level of needs in each of the domains ?

Thanks again, very much appeciated.
 

Brizzle

Registered User
Mar 1, 2019
72
0
Yes, each category was discussed fully and each gave their scoring. They were all generally in agreement but I did get the impression that there had been prior discussion between some of the professionals involved before the meeting. At the end of the meeting the assessor indicated that although it was not a guarantee, she would be recommending approval for funding. The whole process of applying for CHC funding was instigated by social services after my wife moved into care (she was initially part funded by local authority),
Thanks again Andy54, your help is very much appreciated.

So ( and sorry to plague you again, but it is so important I get this right) all 4 professionals contributed to the marking of the DST and it was done live so you could make your feelings known or object to anything you did not agree with regarding the markings before a final recommendation was made?

Sounds very different from my meeting where the social worker knew nothing about my mum and was in fact trying to catch up on things talking with me privately on Teams prior to the main MDT assessment starting. The only people present who knew mums current status and needs were the nursing home who were asked their opinions at the meeting in my presence but then unbeknown to me subsequently not asked to contribute to the DST marking process which was done privately and rather conveniently off camera between the 2 government departments.

Both the CCG assessor and social services cosily got together to achieve IMHO what was best for their respective cash strapped departments rather than what was best and just for my mum.

If the DST checklist had been marked accurately as per the descriptors and subsequently despite the high and severe markings over many domains the CCG had given a genuine and solid case for not granting CHC as per the 4 key indicators I would have read and considered their case. But not following the framework and clearly down marking certain areas of the DST behind closed doors without crucial input from people recently and currently involved in mums care is a non starter for me. I have to fight this one and that is what I will do .
 
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Andy54

Registered User
Sep 24, 2020
162
0
Thanks again Andy54, your help is very much appreciated.

So ( and sorry to plague you again, but it is so important I get this right) all 4 professionals contributed to the marking of the DST and it was done live so you could make your feelings known or object to anything you did not agree with regarding the markings before a final recommendation was made?

Sounds very different from my meeting where the social worker knew nothing about my mum and was in fact trying to catch up on things talking with me privately on Teams prior to the main MDT assessment starting. The only people present who knew mums current status and needs were the nursing home who were asked their opinions at the meeting in my presence but then unbeknown to me subsequently not asked to contribute to the DST marking process which was done privately and rather conveniently off camera between the 2 government departments.

Both the CCG assessor and social services cosily got together to achieve IMHO what was best for their respective cash strapped departments rather than what was best and just for my mum.

If the DST checklist had been marked accurately as per the descriptors and subsequently despite the high and severe markings over many domains the CCG had given a genuine and solid case for not granting CHC as per the 4 key indicators I would have read and considered their case. But not following the framework and clearly down marking certain areas of the DST behind closed doors without crucial input from people recently and currently involved in mums care is a non starter for me. I have to fight this one and that is what I will do .
Yes the discussion and marking was done at the meeting, in my presence, (the meeting took place at the care home) and I had the opportunity to comment or question. My experience of the process does not seem to be typical, social services had instigated the application and the first I knew of it was the invitation to attend the meeting which I got about a week before. In some ways it all seemed too easy and I dread future reviews.
 

Brizzle

Registered User
Mar 1, 2019
72
0
Yes the discussion and marking was done at the meeting, in my presence, (the meeting took place at the care home) and I had the opportunity to comment or question. My experience of the process does not seem to be typical, social services had instigated the application and the first I knew of it was the invitation to attend the meeting which I got about a week before. In some ways it all seemed too easy and I dread future reviews.
Thanks Andy54

That sounds how the MDT meeting should be held with multiple professional input and yourself being fully involved contributing “live” as comments and markings were made. Totally transparent and within what the National framework regards as best and fair practice.

Doing things behind closed doors with a threadbare MDT that has limited knowledge of someone’s current needs is the opposite of good practice This is particularly relevant when only the CCG and Social Services , who each have budgetary financial pressures that could result in potential conflicts of interest are concerned.

Being transparent is so important in this process and if you are confident in your decision making as a CCG assessor you should have no concerns about keeping everything out in the open with full participation. I can only conclude that mum’s assessor was not confident that she would get the result she wanted after the compelling evidence that had been submitted from both myself and the nurses at both the hospital and her new nursing home. Instead she took the “behind closed door option” to the exclusion of others present who might have disagreed with or asked some embarrassingly awkward questions as to how under certain domains she could justify her mark when the descriptor was a fabrication of the truth.
 

Elle3

Registered User
Jun 30, 2016
677
0
Can I ask anybody who has been through the DST process how many people were on the MDT panel that contributed to the marking of the DST. Other than the CCG nurse assessor what other professionals contributed and what capacity did they hold. Also was the coordinator at your meeting independent or as in my case assumed by the CCG nurse who doubled up her role ?

Thank you
Hi Brizzle,

At my dad's meeting back in 2018 there was the 2 people from the CHC team, one was an ex nurse who lead the meeting and I'm not sure about the other lady. There was a Senior nurse from the care home, a member of staff from the care home, myself and my dad joined us. But I was told this wasn't necessary if he would get upset about us discussing him. I said it was OK as he wouldn't understand. The Social worker would have attended but couldn't make that day, so she had already had a meeting with them a couple of days earlier and given them her assessment.

They did attempt at first to try and talk to my dad but soon realised he was unable to communicate coherently.

They first introduced themselves and explained the process. We then went through each of the 12 points with the CHC nurse asking lots of questions and gathering the evidence as she went along (we all had lots of written evidence to support our answers) and then she would suggest what score she felt should be given to dad and asked us what did we think and if we agreed. We actually agreed with each of her decisions and in some cases she even higher-ed his score as she felt it was more appropriate. He scored Severe for his Behaviour and High for both Cognition and Communication and mostly for the others it was Medium or Low. At the end of the meeting she added up all the scores and said she had no problem referring dad to the panel which would be meeting in a few days time.

Within a week I had a phone call from the Social Worker (she was very proactive) to say he had been approved and it was about 2 weeks later I received the paperwork from the CCG. The funding would start as from the day of the assessment. There was a small issue of the care home fees being higher than the funding, but as the panel felt it wouldn't be good to move dad, they agreed to pay the higher rate.

Elle
 

Brizzle

Registered User
Mar 1, 2019
72
0
The good news:- the CHC have acknowledged that ,shall we say, “ the original MDT was not strictly carried within the best interests or intentions of the National Framework “ and have agreed to a new assessment and MDT team.

The bad news:- Reading between the lines I think this meeting might be for “appearance “ sake only. At first I was told by a CCG clinical lead that they would have a new MDT meeting but it would not be necessary to mark the DST again since it had “already been done” . So in effect what I was being told was “ we declare the first MDT meeting not fit for purpose but we are happy to accept their markings of the DST “. .... WHAT ?????? ...it really defies belief.

Anyway I insisted that a new full MDT by a completely new panel should of course involve a new DST being completed. That was rather reluctantly agreed to.

For some “strange” reason there will now be 2 CHC nurses on the panel instead of 1 along with social services ( who are better informed now after visiting mum) and a professional from the nursing home. I know these nurses are supposed to be unbiased but ( and you may call me cynical if you like) there would appear to be a “weighting “ on the CHC side now that an independent nursing professional is actually going to be allowed to contribute to the DST. Other things were said on the phone call about “ just how bad mum had to be “ to get CHC ( and it was about as bad as bad could be) that I already feel the decision has still been made and the new meeting will merely be a charade where mum has been setup to fail.

I very much hope my reading between the lines is wrong but right now I am feeling the full weight of an institution and system that is stacked against you because they are able to dictate things and interpret the rules how only they see fit.

Any thoughts or advice particularly regarding the need for 2 CHC assessors would be most welcome.
 

Brizzle

Registered User
Mar 1, 2019
72
0
My post was being typed while you posted yours Elle.

Well that’s good news regarding the 2 CHC assessors although I guess things might be subjective in that regard due to variances between different CCG regions. I have still been told that the marking of the DST will be done in private in all likelihood due to the fact that following the meeting further evidence might needed.

Mum also scored Severe and High in a number of fields such as cognition and behaviour but IMO and also subsequently that of a new social worker should have received Severe on behaviour .Other fields that were closely inter related such as communication or psychological were marked as moderate or low which was nothing short of ridiculous. Mum for example is almost totally unable to communicate.

Thank you for sharing your experience, I’m glad your Dad got the care he rightly deserved.
 

Dave63

New member
Apr 13, 2022
8
0
So after two years of fighting with the CCG just get mum assessed we finally had an MDT late Dec 21. Then, because of safe guarding issues with mums care home we had to move her a week or so later. The CHC people decided we would now have to have another MDT to make sure mums needs were being met at the new care home. The second MDT took place mid February. At both MDT's she was found eligible subject to the requested written evidence being received by the assessor.

In March we received the outcome letter and copy of the DST (which confirmed the assessors recommendation for full funding). However, the ratification panel disagreed with the assessment and only awarded mum FNC. Despite the fact an assessors recommedation should only be denied under exceptional circumstances and the rationale for doing so should be fully explained, they have neglected to give any reason and refuse my requests to do so. The assessor has suggested the reasons will be given after we appeal!! How do you construct an appeal if you don't know their rationale for denying funding?

Anyway, I'm now thinking of paying for an expert advocate because I'm feeling totally out of my depth with the whole process. The main one appears to be Beacon.

Does anyone have any experience with advocates and if so what was your experience with them?

Sorry for the ramble and thanks for any guidance.

Dave
 

Cat27

Volunteer Moderator
Feb 27, 2015
12,831
0
Merseyside
Welcome to TP @Dave63
I’ve no personal experience of CHC but just wanted to say you’ll get lots of support here so please keep posting.
 

Brizzle

Registered User
Mar 1, 2019
72
0
So after two years of fighting with the CCG just get mum assessed we finally had an MDT late Dec 21. Then, because of safe guarding issues with mums care home we had to move her a week or so later. The CHC people decided we would now have to have another MDT to make sure mums needs were being met at the new care home. The second MDT took place mid February. At both MDT's she was found eligible subject to the requested written evidence being received by the assessor.

In March we received the outcome letter and copy of the DST (which confirmed the assessors recommendation for full funding). However, the ratification panel disagreed with the assessment and only awarded mum FNC. Despite the fact an assessors recommedation should only be denied under exceptional circumstances and the rationale for doing so should be fully explained, they have neglected to give any reason and refuse my requests to do so. The assessor has suggested the reasons will be given after we appeal!! How do you construct an appeal if you don't know their rationale for denying funding?

Anyway, I'm now thinking of paying for an expert advocate because I'm feeling totally out of my depth with the whole process. The main one appears to be Beacon.

Does anyone have any experience with advocates and if so what was your experience with them?

Sorry for the ramble and thanks for any guidance.

Dave
Hi Dave

I am at a very similar stage to you but still waiting the CCG letter announcing their final decision regarding my mum and CHC.

As far as I am aware it is a requirement of the National Framework that the CCG ratification panel have to give their reasons for denying a CHC recommendation from the MDT panel. I would not let this rest until you have been given the reason. Start making a formal complaint immediately to the NHS if this is not forthcoming. Contact them by email, keep everything in writing.

It might also be helpful to know the following which I have taken from the Beacon website : -

“The CCG will then make the final decision, which should – in all but clearly defined exceptional circumstances – uphold the recommendation of the MDT.

A common misconception is that the CCG can choose to reject the MDT recommendation if they disagree with it. However, if the CCG feels there is a mismatch between the evidence and the recommendation it should refer the Decision Support Tool back to the MDT for further work or clarification. It cannot simply overturn the recommendation in favour of its own view. The CCG must not choose to disregard the MDT’s recommendation simply because it disagrees with the recommendation when presented with the same information.

Note the bit about the CCG having to refer the DST back to the MDT for “further work or clarification “ as it “ must not choose to disregard the MDT’s recommendation simply because it disagrees with it “.

Should my mum not be granted CHC I intend to use Beacon since after extensive and exhaustive investigation and extensive record keeping I have a mountain of strong evidence both procedural and factual related that I think together with their legal and NHS related expertise will give Mum an extremely strong case at appeal. However if I am mistaken and that is not the case then due to their reputation for integrity I would expect them to tell me so.

I hope this helps. Good luck.
 
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georgialz

New member
Apr 7, 2022
1
0
So after two years of fighting with the CCG just get mum assessed we finally had an MDT late Dec 21. Then, because of safe guarding issues with mums care home we had to move her a week or so later. The CHC people decided we would now have to have another MDT to make sure mums needs were being met at the new care home. The second MDT took place mid February. At both MDT's she was found eligible subject to the requested written evidence being received by the assessor.

In March we received the outcome letter and copy of the DST (which confirmed the assessors recommendation for full funding). However, the ratification panel disagreed with the assessment and only awarded mum FNC. Despite the fact an assessors recommedation should only be denied under exceptional circumstances and the rationale for doing so should be fully explained, they have neglected to give any reason and refuse my requests to do so. The assessor has suggested the reasons will be given after we appeal!! How do you construct an appeal if you don't know their rationale for denying funding?

Anyway, I'm now thinking of paying for an expert advocate because I'm feeling totally out of my depth with the whole process. The main one appears to be Beacon.

Does anyone have any experience with advocates and if so what was your experience with them?

Sorry for the ramble and thanks for any guidance.

Dave
If you have access to the DST you should be able to see her scores and why she was not found eligible. You are entitled to see this and if there is any reluctance or delay then you can use that in your appeal as incorrect process.

Your appeal should focus on the care domains that you think she scored too low in, and use evidence from care home notes/medical records/personal experience to back it up.
Beacon has some good resources and so does the website called 'caretobedifferent'. It would also be useful to have a look at the national framework (what CHC is supposed to be based on) and quote from this in your appeal.

I have no experience with advocates but it looks like some of them have very good reviews. My family only won our appeal with the backing of our local MP who had a background in social care! Exhaust every avenue that you have the energy for and best of luck.
 

Dave63

New member
Apr 13, 2022
8
0
Thanks for your input @Brizzle and @georgialz , great advice and much appreciated.

@Brizzle I've lost track of the amount of emails sent to the assessor and appeals team requesting the rationale for denying full funding. Keep getting the run around, it's frightening just how dysfunctional the whole process is. This is the main reason for wanting to get an expert advocate involved.

@georgialz The DST shows mums scoring as it was agreed during the MDT. However, in an email, the assessor told me that the ratification panel reduced the scoring of cognition, nutrition and medication based on a QA form received from Community Mental Health (they were not present at the second MDT). Mums previous CMHT nurse had extensive knowledge of mums needs based on 12 months of involvement. As mums new home was in a different area a new CMHT took over just the week prior to the second MDT. I was present when the CMHT doctor visited mum and diagnosed Parkinson's dementia in an assessment which took no more than 15 minutes. It would appear the CCG have disregarded the extensive evidence provided by the previous CMHT in favour of the 15 minute assessment by the new one. It's infuriating and the cynic in me would believe the whole thing is set up to find ways to make people fail.
I'll give Beacon a call after the bank holiday to get their view.
Thanks again for the advice.

Dave
 

Brizzle

Registered User
Mar 1, 2019
72
0
Thanks for your input @Brizzle and @georgialz , great advice and much appreciated.

@Brizzle I've lost track of the amount of emails sent to the assessor and appeals team requesting the rationale for denying full funding. Keep getting the run around, it's frightening just how dysfunctional the whole process is. This is the main reason for wanting to get an expert advocate involved.

@georgialz The DST shows mums scoring as it was agreed during the MDT. However, in an email, the assessor told me that the ratification panel reduced the scoring of cognition, nutrition and medication based on a QA form received from Community Mental Health (they were not present at the second MDT). Mums previous CMHT nurse had extensive knowledge of mums needs based on 12 months of involvement. As mums new home was in a different area a new CMHT took over just the week prior to the second MDT. I was present when the CMHT doctor visited mum and diagnosed Parkinson's dementia in an assessment which took no more than 15 minutes. It would appear the CCG have disregarded the extensive evidence provided by the previous CMHT in favour of the 15 minute assessment by the new one. It's infuriating and the cynic in me would believe the whole thing is set up to find ways to make people fail.
I'll give Beacon a call after the bank holiday to get their view.
Thanks again for the advice.

Dave
Well I am guessing here a bit but it would appear that the “ rationale “ however wrong is based on the Q&A of the second CHMT . However per my post above I would have thought that correct procedure would have dictated that it was for the MDT to do a reassessment based on this new information and then complete the DST again with their consequent recommendation.

If the DST you have been sent is showing no change from what you had expected then you should at least get confirmation from the CCG as to whether the original DST was sent back to the MDT panel for” further work “ .If indeed it was and the panel left the DST unchanged despite the new CHMT info this would certainly imply you have an extremely strong case at appeal . If it was not sent back then this would in my opinion make the whole decision making null and void.

For the CCG to place so much weight on this document when the new CHMT have only had one week of experience with regard to your mum’s care needs is really beyond me. It is recent evidence that the MDT are interested in so that would and should also of included the records and opinions of the previous CHMT who have so much more in depth knowledge of your mum than her current CHMT could possibly acquire in just one week.

Also remember it is not the CCG but the MDT panel that has the exclusive rights to change the DST marking. The ratification panel do not have the power to reduce any of the scoring although with very good and exceptional reason they can reverse the MDT recommendation .

The marking and any recommendation must stay as the MDT panel has dictated and as stated the CCG need an exceptional reason to overturn what they have recommended. I personally would not regard a Q&A document based on one weeks experience that is so obviously in contradiction with your mum’s previous CHMT as an exceptional reason.

Let’s face it who is more likely to know the needs and challenge’s that your mum is faced with , somebody who has been involved for one week or somebody who has been involved for one year ?
 
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Dave63

New member
Apr 13, 2022
8
0
Well I am guessing here a bit but it would appear that the “ rationale “ however wrong is based on the Q&A of the second CHMT . However per my post above I would have thought that correct procedure would have dictated that it was for the MDT to do a reassessment based on this new information and then complete the DST again with their consequent recommendation.

If the DST you have been sent is showing no change from what you had expected then you should at least get confirmation from the CCG as to whether the original DST was sent back to the MDT panel for” further work “ .If indeed it was and the panel left the DST unchanged despite the new CHMT info this would certainly imply you have an extremely strong case at appeal . If it was not sent back then this would in my opinion make the whole decision making null and void.
Hi Brizzle,

The recommendation at the end of the DST is 'Recommended Eligible for CHC'.
However, a week later the assessor has then added the following:

Following consideration of DST and supporting information, I received a QA form advising on the issues with the DST on 04 03 2022.
Query was to discuss SW and either provide additional evidence to support CHC or review and reflect on the recommendation
Following which the MDT reflected on the evidence and agreed that no more additional information was available to support CHC recommendation, nurse & SW reflected on recommendation and both agreed not eligible for CHC as care is routine and predictable on a day to day basis
Forwarded QA to SW on the 04 03 2022 to consider recommendation for FNC
07 03 22 SW responded ‘I am agreeable with FNC review’
They was no further evidence available than that which was already provided for both of us to agree with eligible for FNC recommendation.


There is then a screen grab of a communication between the social worker and the assessor with the social worker agreeing to advice within the communication but which is not shown within the screen grab.
It's worth noting that the social worker who took part in the second MDT was only allocated the week prior to the MDT and other than mums case notes had had no involvement with mum. The previous social worker was superb and spent a lot of time with mum and also fighting our corner in getting mum properly assessed and coordinating with the previous CMHT. Unfortunately, after christmas she was promoted into another role and was not able to stay involved with mums case. It was such a shame because she really was the gold standard. The new social worker not so much!
 

Brizzle

Registered User
Mar 1, 2019
72
0
Hi Brizzle,

The recommendation at the end of the DST is 'Recommended Eligible for CHC'.
However, a week later the assessor has then added the following:

Following consideration of DST and supporting information, I received a QA form advising on the issues with the DST on 04 03 2022.
Query was to discuss SW and either provide additional evidence to support CHC or review and reflect on the recommendation
Following which the MDT reflected on the evidence and agreed that no more additional information was available to support CHC recommendation, nurse & SW reflected on recommendation and both agreed not eligible for CHC as care is routine and predictable on a day to day basis
Forwarded QA to SW on the 04 03 2022 to consider recommendation for FNC
07 03 22 SW responded ‘I am agreeable with FNC review’
They was no further evidence available than that which was already provided for both of us to agree with eligible for FNC recommendation.


There is then a screen grab of a communication between the social worker and the assessor with the social worker agreeing to advice within the communication but which is not shown within the screen grab.
It's worth noting that the social worker who took part in the second MDT was only allocated the week prior to the MDT and other than mums case notes had had no involvement with mum. The previous social worker was superb and spent a lot of time with mum and also fighting our corner in getting mum properly assessed and coordinating with the previous CMHT. Unfortunately, after christmas she was promoted into another role and was not able to stay involved with mums case. It was such a shame because she really was the gold standard. The new social worker not so much!
Hi Dave

From what you have said it would appear that the second MDT panel probably consisted of little more than CHC assessor, the care home and a social worker who had never met your mum . The new CMHT were also not present.

This does not seem to follow the fundamental principle that the MDT panel should where possible consist of all health and social care professionals who are knowledgeable about a persons needs.

Although per the National framework CCGs are allowed to only use two health professionals from different healthcare professions, strictly speaking they should use all the health and social care professionals currently OR RECENTLY INVOLVED in the delivery of a persons care.

It would seem to me that the MDT team were somewhat light on the ground concerning the “knowledgeable “ and “involved “ side of things. You might be able to appeal regarding this claiming you mum was not fairly represented but perish the thought if this was successful you will have to go through DST 3 with a new MDT.

Still if this were to happen you may have time to get someone on board like Beacon should you decide that course of action.

However the thing that concerns me is that as we are now in mid April, have your mum’s new social worker and CHMT( who do not appear to be on your side) now had sufficient time and visits during the interim period to claim they are now “knowledgable “ about your mum’s needs ?

It’s a really difficult choice to make, whether to try for a new CHC assessment or just go straight to appeal. Beacon will give you 90 free minutes , I think that might be your best next move. Good luck.
 

Dave63

New member
Apr 13, 2022
8
0
However the thing that concerns me is that as we are now in mid April, have your mum’s new social worker and CHMT( who do not appear to be on your side) now had sufficient time and visits during the interim period to claim they are now “knowledgable “ about your mum’s needs ?
The new social worker has never visited mum, prior to the assessment or after. I get the impression she was allocated to only sit in on the MDT and if we need any further 'support' then her case will be allocated to someone else. It's what happened when we first seeked support from social services. Nobody from the new CMHT has visited mum since the week prior to her MDT either.
I'll give Beacon a call on Tuesday. There's a couple of others who seem to have very good reviews as well. Although it infuriates me that elderly and vunerable people with obvious health needs are forced to pay for help navigating such a complex and inhuman process.

Thanks so much for your help and advice, it's really appreciated.

Dave
 
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Brizzle

Registered User
Mar 1, 2019
72
0
I agree Dave it is indeed a very complex and at times IMO unethical process that can be exasperated by certain CCG’s who waver away from the principals and guidelines of the National Framework and where if they “don’t like” the first professional opinion they go somewhere else until they get an alternative opinion that is a “better fit” for their ultimate end game objective.

You said in an earlier post , “ the cynic in me would believe the whole thing is set up to find ways to make people fail” and having been through the process 3 times myself I can concur with that, particularly if you live in an area where there is a 50 to 75% plus less chance you will get CHC funding when compared to some other areas of the country.

After digging in deep I finally got my mum a fair MDT hearing with the correct people present . That still doesn’t mean however my mum will necessarily get a fair result. I am still waiting the decision regarding Mum but for reasons I won’t go into right now am feeling very pessimistic when the MDT meeting in normal circumstances should have left me feeling to the contrary. Such is a “system” that leaves many of us cynical to the extent we do not trust the very people we should unequivocally have trust in.

I wish you luck with whatever direction you choose to take.If things do not go my mums way we might well be fighting our appeals around the same time.
 

Dave63

New member
Apr 13, 2022
8
0
It does make you wonder if Rear Admiral Philip Mathias, and his experience of dealing with bureaucracy on an industrial scale at the MOD, failed to prove the injustice of the CHC system in the high court then what hope is there for the ordinary man/woman in the street? Although to be fair, I don't think he failed to prove it, I think the system is just corrupt up to the highest level.

I wish you well with your mums MDT decision and fingers crossed no appeal will be necessary.