Advice

monkeyspanner

There is a legal obligation on the NHS to fund the care of someone who has a primary healthcare need i.e. where their care needs are health related rather than domestic. This funding is not means tested and the care can be provided in any setting including the persons own home.

The need for this funding is assessed by the local PCT (primary healthcare trust). An initial assessment should be carried out when someone is discharged from hospital to a care home but in other circumstances an assessment may need to be requested.

For obvious reasons the NHS does not go out of its way to make this funding well known and it is notoriously difficult to obtain. There is also a postcode lottery as the rules of assessment are interpreted differently in each PCT areas. A new system of assessment was introduced in Oct 2007 in an attempt to eliminate the assessment variation but the situation has only improved slightly.

In the first instance I suggest you look at this explanation of the CHC assessment process and see if you think your relative would qualify.
http://www.counselandcare.org.uk/assets/library/documents/40_Continuing_healthcare_-_understanding_the_assessment_process_2009.pdf

There is a long thread on this forum for more information and peoples experience of trying to get CHC funding for their relatives, here is a link to the thread.
https://forums.moneysavingexpert.com/discussion/800521

Savvy_Sue

Ignore what I said, monkeyspanner has put it so much better, and is very knowledgeable about all this, sadly from bitter experience!

frannyann

Mihangel wrote: »

can you explain more?

Monkeyspanner has explained it much better than I could have! PCT's seem to like keeping people in the dark about CHC funded care :mad: One trick is to assess the person without a family member present, when we all know pride is very important to an aging person who may deny their true level of need.

pollypenny

I definitely agree with Frannyann, Mike.

My dad still thought he was a big string miner who could do everything and was pushing to be discharged from hospital after breaking his hip.

He lasted a week at home.

monkeyspanner

There are a number of ways the PCT's try to avoid this funding.
-Lack of publicity
-Telling patients and their relatives "you have to be at death's door to get CHC funding"
-Not informing anyone that an initial assessment has or will be carried out prior to hospital discharge.
-Not giving the patients the result of the initial assessment so they have no opportunity to challenge the decision not to recommend a full assessment.
-Deliberately underestimating the seriousness of a patients health needs.
-Not counting well managed health needs as a need which has to be assessed.
-Snap assessments so a family cannot fight the patient's corner during an assessment.
-Not providing clear guidlines as to what domain scores will result in a successful funding award.
-Re-assessments after a short period of time.
-Not taking the patients full medical history into account
-Categorising degenerative brain conditions e.g. dementia as domestic ("its old age dear") rather than medical.
-"Mislaying" patient records.
-Not providing full information to IRPs (independant review panels)
-Delaying assessments and then refusing to back date awards because "we have no evidence for that period".

Knowledge is power. Inform yourself of the system and demonstrate that knowledge. Keep copious records. If you don't agree with the assessors decision say so and insist they record your objection.

The worst part of this process is that it takes your attention away from your relative just at the time they are at their most vulnerable and need you most. It is very sad that in this society the elderly are valued the least.