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Views Appreciated on CCG Response to CHC Appeal

Maaarrghk

Registered User
Jan 2, 2013
13
My Mum recently had a DST assessment for CHC and was turned down. I am appealing the decision.

My understanding was that I would write to the CCG to let them know of my intention to appeal and then submit my appeal in due course, which I would base on the DST, social workers report and the way it was all conducted, (mental health report done behind my back, no demonstration of Mums weight bearing abilities despite repeated requests at DST meeting at Care Home).

I have just had the attached response (sorry for the amount of attachments) and am deeply suspicious. There is another sheet to the questionaire, but I think you get the drift and forum software seems to have a limit as to how much I can attach.

First the cover letter, which is the second document that you will see below. So, the Appeals Co-ordinator (Squiggle by name, Sqiggle by nature it would appear - who is this person?) has decided that for me to proceed with the appeal, I must supply a whole wad of information that I never had to supply when setting up the DST assessment - I just wrote a letter (then another, then a warning that if they did not respond I would complain) and the ball started rolling. No proof of anything required.
Are they just giving me hoops to jump through for the sake of it here, as a first attempt to put me off? And who is the mysterious "Squiggle" who is dealing with this? Am I not entitled to a simple name of a person who is dealing with this?

Second is the Consent Form (first document below) and its attached list of requirements for me to prove that I am entitled to act on my Mums behalf in appealing the decision of the assessment that I was allowed set up without having to provide any such proof. Quite absurd, but what do others think? Is the CCG within their rights to ask for this when they plainly did not require it in the first place? Are they simply engaging in an exercise of time wasting?

Third is the questionaire, and I am a bit suspicious. An attempt to constrain my arguments perhaps? Not much room in some of those boxes and no space or opportunity to mention my own reservations as to how the assessment was carried out, where I think that the wool was being pulled over my eyes and the fact that no fully written response other than "No primary health need, all needs adequately managed" was given by the decision panel. Hardly a fully written response as required by the National Framework, which I am still wading through (page 50 of 140 so far).

Can they refuse the appeal, if I disregard the questionaire and provide fuller information in my own format? I am concerned that if I just fill in this form they will take it as the entire and full appeal.

Any advice, comments and thoughts appreciated, however, time is ticking away and I need to make a response soon that won't get knocked back due to my not doing things the CCG's way.
 

Attachments

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Saffie

Registered User
Mar 26, 2011
22,507
Near Southampton
To be honest, I think the room allocated for your responses is very similar to that which is on the checklist nd the DST form so I don't think it is intended to discourage you from appealing, much though they'd probably like to!

You do seem to need proof of identity for nearly everything these days so I wouldn't place too much significance on that reqest either.
The necessity for proof of LPA or Deputyship is consistent with most things concerning anything we do concerning the finances or offical dealings we carry out on behalf of those we represent. Where applicable, anyone is able to apply for CHC funding initially so that could be why it wasn't necessary in the first place. However, now you are undertaking an offical appeal, so it is different.

I know we are inclined to distrust anything concerning the CCG and the CHC funding but I assume they have to follow the correct procedure, even if reluctantly.

Mind you, why I'm saying that I don't know as I've not heard a word since September when I rang to ask if they were aware my husband had died whilst awaiting a delayed DST meeting. I would hear the outcome from the panel ( without seeing any of the reams of evidence I had gathered) in a week! Long week - good thing I wasn't holding my breath!
Good luck.
 

Pickles53

Registered User
Feb 25, 2014
2,474
Radcliffe on Trent
There seems nothing to say that you cannot add additional information if there is not enough space on the form. If you don't think it covers all the points you need to make, type them up separately, link them to one of the questions on the form, and make sure you cross-reference the extra sheets on the form itself (eg 'please refer to page 1 of additional information attached'). That way if any if the paperwork gets detached you will be able to prove from the form alone that there was further information to consider.

I think the questionnaire format is for two reasons, one is to ensure that you include all the relevant information, and the other is to have it in a logical order for the people considering the appeal. It's not necessarily to put you off. It's similar to the reasons a lot of companies use application forms for jobs rather than just inviting people to write in.
 

Saffie

Registered User
Mar 26, 2011
22,507
Near Southampton
I'd be inclined to write out the various responses and then abbreviate them for the actual form so that the salient points are all included.
As Pickles has said, you can also add anything extra you have to say as an attachment.

The questionnaire format is probably in that style because it follows the same areas of the DST tool.
 
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geum123

Registered User
May 20, 2009
4,604
I'd insert a table into word, so that you can copy pages 2,3 & 4 and then type in your comments.
The table size will adjust according to what you type.
 

Maaarrghk

Registered User
Jan 2, 2013
13
Thanks for your replies.

I am thinking also of a note on the front of the questionaire to the effect that this does not constitute the full and final substance of my appeal and should not be used as an appeal in itself. Could anyone help me with the wording here?

I would also repeat that statement on a covering letter stapled to the front of the questionaire that also asks who the mysterious "Squiggle" might be. (Oh come on now, don't be so shy - if my teeth don't meet in the middle, I'm only playing.....)

As I am still not half way through my first reading of the National Framework, I want to give myself as much chance as possible of making relevant additions to my arguments as and when I spot them.
 

Pickles53

Registered User
Feb 25, 2014
2,474
Radcliffe on Trent
Re the wording.... Perhaps something to the effect that you 'reserve your right to submit additional evidence prior to the appeal' as well as stating that this submission is not your 'full and final response'.

However from a procedural point of view, has a deadline been set for all written information to be submitted? This would not be unreasonable, and if so you should comply. Members of the appeal panel have to have some time to consider the paperwork before an appeal hearing, if that's the right word for the meeting.
 

Maaarrghk

Registered User
Jan 2, 2013
13
My understanding is that I have 3 months from the date of the DST to indicate that I wish to appeal and I am well within that time frame Pickles.

They have not at this time however given any deadline for submission of my full response. I guess that they are awaiting the completed forms etc first.

Your pointers on the wording are appreciated. Thank you.
 

Mrs Collins

Registered User
Feb 6, 2014
1
The whole process of CHC funding is enormously difficult. I have been fighting it for 6 years on behalf of my mother and been through the appeals process several times. Never seen all the forms that you are expected to complete. Assuming that you have POA in place then I don't see why you should fill all that out. I have not faith in the CCG what so ever and don't trust them and wonder how they expect you (please no offence!) to fill out these forms as an "unqualified" person. I had a DST thrown out by the CCG because they maintained that the people who carried it out were not suitably qualified which is a load of rubbish. Stall tactics :mad: So......... if you do fill it out will they use that in the appeal against you. Be very careful.
I have enlisted the help of my MP because I went nearly 2 years with no movement on the case, letters were ignored....lost....etc etc. Although my MP technically doesn't have any say in the process she at least makes sure the CCG reply to me and keep things moving. My CCG chief executive absolutely hates me because I refuse to back down.
If I were you I would put together a statement as to why you are appealing the decision. Do you have a copy of the DST, if not you should and if you can get medical records to back up the case do so. Any little shred of information could be important. Most places will charge £50 for the entire set of medical records, worth it for what you could get back - hopefully!
Good luck, stay strong and keep fighting!!
 
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