The problem we've encountered with my mum is the absolute determination on the part of the CCG to avoid CHC wherever possible because of funding problems.
So for example having recently passed a checklist with 3 A's and 4 B's, they then wrote to say they wouldn't be taking this forward to a full CHC assessment because they claimed there was "no material change" in mum's condition in over 2 years since they assessed her last and took her CHC eligibility away. Absolute rubbish of course, but they know that you're pretty powerless to do much except go through an appeals process. We've just finished appealing the August 2012 decision! They knew she was CHC eligible, but simply refused to assess her based on a lie.
We've fought the withdrawal of CHC with all our ability and sheer hard work, but for example the Ombudsman has said there was no lack of process in taking a year from assessment to decision (the framework explicitly says 28 days), and even went on to say my mother was "favoured" (their word) by this delay because she was still being funded. So never mind the complete lack of process, we're supposed to feel lucky. Utter nonsense and actually quite insulting.
The IRP said that although my mum's nursing needs were "increasing" (their actual word), she didn't qualify because having dementia didn't make a person CHC eligible. But hang on - we were there because her CHC had been withdrawn, so if her needs were "increasing", wouldn't she be even more eligible for CHC? But let's not allow logic and evidence to get in the way. The IRP was clearly going to support the CCG who weren't criticised in the slightest, even over things like going to see my mother behind the family's back despite us writing to say they were to stop doing it. And then having found my mother very different from how they reported her in August 2012 in that much later visit over a year on, omitting to mention subsequently they had been to the CH to see her because the evidence didn't suit their purpose - until I found out by chance. I wouldn't have believed this sort of behaviour was possible by healthcare professionals unless I'd seen it for myself. Total bullies.
There is clear evidence from openly available government statistics that our CCG has one of the lowest CHC eligibility rates per capita in the whole of NHS England, so there is a degree of postcode lottery and the pressures that some CHC assessors and their managers are under to be outcome driven also must have an impact.
In short, it's far from a level playing field, and if other public servants in other professions (police etc) breached very clear guidelines and rules so blatantly, I suspect they could be in serious trouble. And the appeals process at all levels, including the PHSO, is far from independent and leans towards supporting the NHS, however compelling the evidence. Sadly, I can't see the situation getting any better, but it needs to be gripped soon as right now it's a complete shambles.
I would never dissuade anyone from looking to obtain CHC, but my advice would be to be prepared for an uphill struggle. Hopefully CCGs will do the right thing though (as they did with mum in 2009, until the funding pressures emerged).