NHS Continuing Healthcare funding cap?

inholms

Yes, I now understand this and as you will appreciate as we only have two parents, most of us take time to 'get up to speed' I think now that having more knowledge of the subject I am more concerned about the process brought in by the Tories in 2013:
it may well be that my father will fail an appeal ( I'm sure he will) but what I find most disturbing is the process; The government has created a 'tool' that is so distorted and weighted, most decent people have been manoeuvred and shafted out of their rights (you know, the ones they thought they would get when they voted for the inception of the NHS).
I'm also concerned as who selects the people who undertake the assessments, both for the NHS and Social Services; It cannot be a coincidence that the dragons that do this work across the country seem to be generally nasty and seem derive pleasure from telling people they will not get funding. I wonder if there a bonuses involved?!!!!!
It's like living in Russia or the old Communist Block!

inholms

Sorry, there's one more point I forgot to mention. My father has been in the residential home for three years and until recently he was 'Residential' status. As soon as he became incontinent he was moved to the 'Nursing' floor, and the fees were whacked up by another £200 a week! They don't seem to follow the same care / nursing definitions as the NHS. Do you see the dichotomy we are facing?

pineapple123

Inhomes I do really understand your fustration. Those who decide if CHC funding should be granted have very strict guidelines. A CHC fully funded care place could be £1,000 + a week the care recipent is also entitled to keep all there state penson, private penson, etc so very expensive to fund an ever increasing number of people with health and care needs.

Just to add the fees for the home went up because of requiring a greater amount of nursing care intervention and thus more staff, a higher staff care reciever ratio. There maybe also a need for extra pads, special equipment ie air bed etc. Sorry a rise in fees is generally standard practise in many homes.

L-J-R

My sympathies to anyone fighting the system. I failed to get funding for my mum, until posthumously, the authorities agreed that for the last six months of her life, her needs exceeded what they deemed social care. Her needs hadn't changed since I first submitted her details - unable to move independently so liable to pressure sores, doubly incontinent, thus exacerbating the tendency to sores, prone to choking, but by far the worst of her conditions, to my mind, was her inability to communicate - pain or fear - a dimension that didn't fit into their 'score card'. While there were people on the panels of the meetings I addressed who showed sympathy, whatever their vote was once I had left, there were individuals who were openly as hard as nails. I couldn't believe they came from the nursing profession in which my mother had worked for almost half a century.

inholms

Pineapple,
you seem to be supporting this disgraceful scam. Why?
This is going on secretly across the the country. Who are these 'hard as nails' people? under who's authority are they working?
You may ask 'what has this got to do with this forum?'
Well, let me explain; My father, fought for his country, paid his NI all his 50 years working life and voted for the inception of the NHS. Do you honestly think that the way he has been tricked and intimidated is what he and everyone else like him is what he thought he was going to get? No! this is a national disgrace and the reason the 'Dragons' are employed is to intimidate and frighten decent people from fighting their case;in other words stopping them from getting their rightful benefits.
Thats what it has got to do with this site and it has to be exposed and publicly debated.

converted

inholms wrote: »

Pineapple,
you seem to be supporting this disgraceful scam. Why?
This is going on secretly across the the country. Who are these 'hard as nails' people? under who's authority are they working?
You may ask 'what has this got to do with this forum?'
Well, let me explain; My father, fought for his country, paid his NI all his 50 years working life and voted for the inception of the NHS. Do you honestly think that the way he has been tricked and intimidated is what he and everyone else like him is what he thought he was going to get? No! this is a national disgrace and the reason the 'Dragons' are employed is to intimidate and frighten decent people from fighting their case;in other words stopping them from getting their rightful benefits.
Thats what it has got to do with this site and it has to be exposed and publicly debated.

Pineapple is not necessarily supporting the system, they just have to work within the guidelines and criteria of the system (and the system comes through the government not any "dragon"). It is not going on secretly as there are clear guidelines, which can only be met through hard evidence that the needs are primarily health needs and families are involved in the assessment and can put their views across and appeal. Having worked all your days and paid into the system is not a criteria for meeting the eligibility, people who have never worked a day in their lives can qualify if they meet the criteria (unfair but a fact of life). They are not ""dragons" who are employed, but professionals who have to follow the guidelines and find the hard evidence which shows each individual meets the criteria so they can make the argument that the person meets the criteria or not. It is not an easy job as any human being with thoughts and feeling would want the person if they have a primary health need to meet the criteria to get the health funding they are entitled to . But on the other hand if there was not a qualifying criteria and if people were entitled to NHS funding because they were doubly incontinent etc it would not be long before the country was bankrupt.


Unfortunately inholms you seem to have been very unlucky to have had a shower of "dragons" both from health and social work ", but this is not indicative of "dragons" being employed for the sole purpose of not awarding NHSCC. and neither do these "nasty people" get paid any kind of bonus for undertaking their assessments they just do their jobs.

inholms

Sorry, by my book they are quislings. No professional should morally be involved in a government instigated process that works against the best interests of the decent hard working people of this country. If they had any pride they would refuse to do the governements dirty work and I am shocked that it is happening in our country.

lessonlearned

Inholm - I just caught this thread and wanted to express my sympathy.

I had all this with my darling late husband. It took me three attempts to,get him DLA and then when he finally went into the nursing home it took another three attempts to get CHC.

Hold in your mind a picture of Stephen Hawking and that was my husband. Totally paralysed from th eneck down, unable to swallow or speak.

Unlike Stephen Hawking he was not given fancy "talking machines" to help him communicate, we had a makeshift alphabet board, which I pointed to the letters and he blinked.......and still I had to fight them tooth and nail. He was unable to sit unsupported, could not move, had to be turned in bed etc

He died last August.

Now I have the same battle with my mother., who has multiple and complex needs. we had our first CHC assessment last week. I just know they will throw it out, so i will just keep fighting them. I don't care how many appeals it takes I will not let them get away with this.

My father is 89 and is utterly bewildered by the whole process..

Both my husband and my mother are "lucky" in that they have me to fight their corner to ensure that they get the right treatment and funding. So many people have no one to be their advocate.

I am intelligent, methodical, resourceful and, when necessary, I can be sheer bloody minded. When required I too can be a dragon - I can breathe fire if breathing fire is required.

However, I agree with you whole heartedly the situation is a scandal and a disgrace. It should not have to come down to a pitched battle to get what should be given as a right.

I am determined that my parents get justice and fairness, I will keep on fighting till my mother gets her full funding or dies.

I just wish I didn't have to go through all this again. It is utterly exhausting and I feel drained. I just want to bury my head in the sand but I cant, I have to keep going even though I know the stress is making me ill.

You and I are not alone in this. These are not isolated cases.

My husband was ill for nine long years. During that time I spoke to a lot of sick people and their families. The cases of financial hardship I heard were heartbreaking.

In our case I was facing bankruptcy and had to sell our much loved family home to survive.

This is beyond outrageous.

The NHS should stop wasting money on boob jobs, gastric bypass operations for the obese etc and get on with its job of providing health care for the sick and needy.

monkeyspanner

pineapple123 wrote: »

Inholms , CHC funding is based on health needs not nursing needs. A person such as your father has many nursing needs but does he require specialist nurse care for example an individual may need help with feeding, anyone can feed someone (nursing need) but has that person also been assessed as have difficulty swallowing, risk of choking maybe need thickend fluids etc (this is now a health need) and should mean in a care setting only someone who is trained not necessary a qualified nurse should be feeding that person. Can you see the difference. CHC is complex difficult to obtain depends on having several health needs and can be taken away even after its been awarded.

This should be balanced against the fact that in order to qualify for CHC you do not need to be cared for by a qualified nurse and the care can be provided in any setting including your own home.

Unfortunately the introduction of the national framework has not solved either the postcode lottery or the various ways in which the infirm are denied the rights the courts have confirmed. The medical "experts" that run this system are indeed experts in twisting the facts that are so obvious. They are gatekeepers and their task is not to assess a patient's needs but to deny the patient's rights by any means possible.
It will be a very rare employee of the NHS that will risk their career and wage to say the current interpretation of the CHC assessment system is wrong and contrary to the High court judgement that necessitated the introduction of CHC funding.

cattermole

The Alzheimer's Society will link relatives up for support from volunteers who have specialist knowledge of getting CHC for their own loved ones.

I used this service with my father although I was already pretty knowledgeable of the system.

It isn't unheard of for Health to cap CHC costs either for elderly they did in my Dad's authority. In the same way LA's are capping non residential care in the home. None of it legal but its common place.

The only area it is not so difficult to get CHC is in Learning Disabilities with additional and profound needs this is because they have separate health funding. Most people in Nursing homes should probably be on CHC but there just isn't the funding for it. So all the best dragons are employed to ration the funding. Its got much worse over the last 5 years.

Scoring highs does not necessarily guarantee CHC. Proving its a fluctuating condition which requires direct nursing or health intervention is crucial in other words "acute" which would be similar to being managed in hospital. For example being double incontinent is not enough to score high. Manual evacuation or some other factor would be needed or a catheter in situ, continual infections etc.. Sores would go on the grade of sore and homes tend to mislead on grades as well often to cover up poor care and management.

Its all a terribly sad state of affairs not just from a cost point of view but quality of care.