NHS Continuing Healthcare - about to join battle

anamenottaken

beaujolais-nouveau wrote: »

Yes, I have asked the PCT in the West Country, where my mother lived, and where she was discharged straight from hospital to a care home, to conduct a retrospective assessment. They failed completely to conduct an NHS Continuing Health Care needs assessment before she left hospital, and I can prove it from contemporary documents.

So is the "West Country PCT" the "local PCT"? Seems I must have misunderstood, I thought she had moved to a different area and the local PCT was the one in which the care home is situated.

beaujolais-nouveau

anamenottaken wrote: »

So is the "West Country PCT" the "local PCT"? Seems I must have misunderstood, I thought she had moved to a different area and the local PCT was the one in which the care home is situated.

Her local PCT is in East Anglia, ie where the nursing home in which she now lives is situated.

anamenottaken

beaujolais-nouveau wrote: »

Her local PCT is in East Anglia, ie where the nursing home in which she now lives is situated.

I thought the responsibility remained with the PCT of the area that the person was in at the time of the need to enter a nursing home. That's why I thought you might be applying to the wrong PCT. Even if she were to continue to live in the same nursing home as now (East Anglia), the PCT responsible for this would be the West Country one.

I'm not 100% sure about that but, unless you are, could you check it out?

Or perhaps someone else reading this thread can confirm or refute the idea I have about responsibility.

beaujolais-nouveau

anamenottaken wrote: »

I'm not 100% sure about that but, unless you are, could you check it out?

I think you are right but I have now written to the second PCT (East Anglia) to ask why they are getting involved in doing CHC assessments at all of my mother when - assuming we win - it is the West Country NHS that will have to refund all fees so far paid and pay her fees for her remaining years in the East Anglia nursing home.

In the meantime, the West Country NHS have acknowledged that they did not carry out a continuing care assessment when they should have done, ie before my mother was discharged from hospital to the care home in the West Country. They seem to think that I should be satisfied with an apology.

Trebor16

beaujolais-nouveau wrote: »

Her local PCT is in East Anglia, ie where the nursing home in which she now lives is situated.

Are you at liberty to say which PCT you are dealing with? I ask because I have been dealing with an East Anglian PCT since July 2007 over the costs of my father's EMI nursing home placement and to say it has been a frustrating experience is an understatement.

beaujolais-nouveau

Trebor16 wrote: »

Are you at liberty to say which PCT you are dealing with?

It is the same one as yours.

tubsmacker

Having had an assessment where a recommendation to a panel to award funding has been agreed under the DST. What is the situation where funding is declined and the patient (Mum) is still in hospital. I have refused to allow the involvement of the SS or to sign any consent for them to be involved. Where will the PCT go when payment is refused? or if they do award funding for 3 months and then demands for payment are refused. My understanding is that only the court of appeal can authorise such payment if the dispute is defended. Is this so? I intend to dig my heels in and would appreciate anyone's comments about similar cases.

Norman-B

Sincere best wishes to OP. I had a battle with my late fathers PCT. They refused him CC and I appealed. Lost the first appeal and went into round two. Cut a long story short, I won after a very heated meeting. I found the 5 months fighting the PCT a most depressing time.
Sadly, my dad died less than 6 weeks later.

Keep fighting!

tubsmacker

Norman-B wrote: »

Sincere best wishes to OP. I had a battle with my late fathers PCT. They refused him CC and I appealed. Lost the first appeal and went into round two. Cut a long story short, I won after a very heated meeting. I found the 5 months fighting the PCT a most depressing time.
Sadly, my dad died less than 6 weeks later.

Keep fighting!

Thanks for the message of support Norman. I'm saddened to hear your Father passed away, but I can imagine how proud he would have been that you fought his case and won at that difficult time.
Fight on indeed. Absolutely!

tubsmacker

Willman_Rodders wrote: »

Goodluck beaujolais-nouveau. I wish you success.


And so that's it. Dad will probably never qualify.

The assessor did explain that the assesment was about needing specialist nursing care for my father, and not general nursing care 24/7.

To add insult to injury the care home fees have now used up all dad's savings. When we mentioned this the assessor explained that if we approached Social Services they would defer funding until any challenge to the NHS assessment had been resolved, which could be some time off.

So where do we go now? It is so frustrating.

I hope the above gives yourself and other readers a snippet of information as to how the system appears to work. As Dad's assessor said ... "It's all about funding. And there isn't any available at present. Existing cases are now being reviewed early, with existing and long-standing recipitants now being declined at review."

Anyway as I said ... Goodluck beaujolais-nouveau. I wish you success. If you find the solution please let us know.

Hi William, As I would see it, I think your Dad should qualify on the Basis that the DST Assessment procedure is flawed and wrongly applied.
I seem to remember one of the landmark judgements made it quite clear that there was no requirement for specialist Nursing to qualify for CHC.
I believe the first step is to refuse to allow Social Services involvement. (Sign Nothing) whatsoever) Otherwise the PCT will hand responsibility to them.
Seemingly there is no mention in the 1946 health act about having to 'qualify for funding on a scoring system' Needs are Needs. End of story.