CHC (Continuing Healthcare) support thread

stanleypj

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Dec 8, 2011
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North West
I think the point has been made before that it is a commercial site but it's very good to hear that you find the site useful and got free advice, missmarple.
 

missmarple

Registered User
Jan 14, 2013
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Well that's right StanleyPJ my view is that in a battle why not make use of all the weapons at our disposal!
 

stanleypj

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Dec 8, 2011
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North West
I tried to find out as much as I could about the process. There are already many links on this thread that will help you to do this.

It would be a good idea to go through the Decision Support Tool and decide the 'scores' you would apply in each domain with examples of the evidence that supports each score. You can then take all this to the meeting and challenge, with the evidence, any score you do not agree with.
 

AlsoConfused

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Sep 17, 2010
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It would be a good idea to go through the Decision Support Tool and decide the 'scores' you would apply in each domain with examples of the evidence that supports each score

I've done this with the Checklist form. It's a very useful process - you may not realise how much evidence is on your side until you've gone through it!
 

JTK

Registered User
Nov 23, 2015
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Information Gathering By MDTs/CCGs Before Assessments - What Are The Rules?

It seems to be practice now for multidisciplinary teams, at the request of CCGs, to send people to visit candidates for NHS Continuing Health Care immediately prior (and I am not talking about the Checklist procedure) to the full assessment taking place to gather proof that may help suggest what one or more of the domain scores should be awarded when a decision support tool is completed.

Where this practice happens when a candidate for NHSCHC is in a care home:

1. Should the representative of a candidate for NHSCHC be informed that such visits will take place, or have taken place, and should a representative be given an opportunity to be present?

2. Should care homes notify a NHSCHC candidate’s representative that such a visit has taken place?

3. Should someone from the care home be present when the person(s) are visiting the NHSCHC candidate (particularly if the candidate’s representative has not been made aware that such a visit has taken place)?
 

sleepless

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Feb 19, 2010
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The Sweet North
rageineden:

The coordinator told us even if we win we will only get a care home place not care in the home which is the most suitable route for our relative. We were told the CCG just don't do that under any circumstances.

I believe that this would be unlawful. There's a principle that the setting of the care should not affect a decision whether to fund. It's the needs that matter, not the setting. I'll try and find the exact quote tomorrow.

When I mentioned CHC to my parent's social worker I was informed that it only applied to people in a nursing home, not a residential home.
This was incorrect. Anyone in residential home, nursing home, or their own home is eligible to be assessed.

Later, when I complained that the process was being carried out contrary to the Framework, a person at the CCG informed me that they do not comply with the Framework, but carry out assessments in the way that suits them.

Well done anyone who gets through it still sane.
 

stanleypj

Registered User
Dec 8, 2011
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North West
When I mentioned CHC to my parent's social worker I was informed that it only applied to people in a nursing home, not a residential home.
This was incorrect. Anyone in residential home, nursing home, or their own home is eligible to be assessed.

Later, when I complained that the process was being carried out contrary to the Framework, a person at the CCG informed me that they do not comply with the Framework, but carry out assessments in the way that suits them.

Well done anyone who gets through it still sane.

This attitude may not be uncommon, but the fact that they are prepared to admit it is......surprising.

Still, as I said, discrimination against a particular setting is unlawful. My understanding is that the legislation forbids it.
 

sleepless

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Feb 19, 2010
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The Sweet North
This attitude may not be uncommon, but the fact that they are prepared to admit it is......surprising.

Still, as I said, discrimination against a particular setting is unlawful. My understanding is that the legislation forbids it.

re my post above, the CCG tell me it is not law (the Framework and Guidance) and CCGs can interpret it in which ever way suits them.

Independent advice insists this is wrong.
I say this to CCG.
They say they have always done it this way.

nb I am referring to the initial stage of assessment, not to the later stage eg. DST.
It certainly leaves me with no confidence in the integrity of the whole system.
 

nitram

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Apr 6, 2011
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Bury
The framework and guidance are not law, the CCG can set up and use whatever local protocol they like as long as it conforms to the various Acts.
 

sleepless

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Feb 19, 2010
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The Sweet North
The framework and guidance are not law, the CCG can set up and use whatever local protocol they like as long as it conforms to the various Acts.

This is interesting, nitram.
Various websites I looked at direct one to the National Framework, which is obviously not adhered to, so this wastes time.
Independent advice says the Framework should be followed, more time wasted then?

I need an idiots guide to How It Really Has To Be Done, in plain unambiguous language.
Because caring for my husband leaves me with no time to waste really.

But then, if it was made simple........
 

stanleypj

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Dec 8, 2011
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North West
Do you have regular contact with the District Nurse service sleepless? I only ask because this was our route to a successful application and I don't know how or whether I would have got us there on my own. Like many people I started out knowing very little about CHC. I had been 'coping' for many years and just assumed that I would have to carry on, come what may, getting odd bits of help from wherever.
 

nitram

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Apr 6, 2011
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Bury
"Thanks nitram. Shouldn't 'case law' be added to 'the various Acts'?"

Yes, but Acts are definitive whereas with case law there can be an argument as to whether or not it applies.

For instance, it would probably take an expensive legal argument to prove that the CCG's decision was not ‘Coughlan compliant’
 

sleepless

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Feb 19, 2010
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The Sweet North
Do you have regular contact with the District Nurse service sleepless? I only ask because this was our route to a successful application and I don't know how or whether I would have got us there on my own. Like many people I started out knowing very little about CHC. I had been 'coping' for many years and just assumed that I would have to carry on, come what may, getting odd bits of help from wherever.

Stanley, my concerns relate to my dad who is in a care home.
 

JTK

Registered User
Nov 23, 2015
22
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Drug Therapy Domain

Another thing I don't understand.

Why is it necessary for someone who is in chronic pain to have to be dosed up permanently on morphine before a MDT/CCG will even consider a "severe" in the drug therapy domain?