Continuing Health Care - Preparing to fight PCT's decision

EdInvestor

margaretclare wrote: »

This seems to be what the authorities can't get their heads around. They seem to be fixated with 'nursing only goes on inside hospitals'.

They also seem to be fixated with the idea that dementia is not an illness but a "normal consequence of ageing." Thus it falls under the 'care' heading - paid for by the individual or the council, not the 'medical' heading, paid for by the NHS.

Given that around 70% of people in care homes have dementia, it is not surprising that the NHS is desperate to avoid having to pay the fees for these people.It all comes down to money in the end.

But pretending it isn't an illness is a step too far. The system is wildly overdue for reform.

fredsnail

http://wales.gov.uk/consultation/dhss/payingforcare/payingforcaree.pdf?lang=en

There is currently a consultation going on for Wales about paying for care - deadline for responses is 28 Feb.

fs

mike88

Thanks for the replies. I shall read the links in detail. In response to Monkeyspanner the Health Board is Cardiff and Vale.

What I meant about no system in Wales is that they seem to be in between two systems and that being the case it may be possible to play one off against the other.

If responsibility is due solely to the Health Board I wonder why my mother's doctor referred me to Social Services and it was they who said they would arrange for an assessment even though they have absolutely no financial involvement.

I think I might ring them again on Monday in order to find out precisely what is going on. Unfortuneately the person I am dealing with does'nt seem to have a clue and keeps referring my questions to a manager. This does not bode well.

margaretclare

They also seem to be fixated with the idea that dementia is not an illness but a "normal consequence of ageing." Thus it falls under the 'care' heading - paid for by the individual or the council, not the 'medical' heading, paid for by the NHS.

If it really was the case that dementia is 'a normal consequence of ageing' then we would ALL have it and it would start at a definite age. It would be like having wrinkles, which no one can escape no matter what skin preparations we use. Nor does it start at the same age in everyone who gets it. Many sufferers have a non-affected spouse - a recent example is Bonnie, the wife of John Suchet, the broadcaster.

All of us can point to people we know well who are as 'sharp as a button' regardless of their age. I think of a man called Harry Patch, one of the few survivors of WW1, well past his century, but worth listening to. A man near here still plays the church organ which he first played in the 1920s. I can think of many others.

So when does it actually start, if it is a 'normal consequence of ageing'? I'm nearly 74, DH is 74 and neither of us has problems with memory (except the ones we always had and which many people have, like 'where did I put the car keys'?)

Errata

Margaret, I take your point but some things are more likely to happen depending on age. That doesn't mean that everyone will experience dementia because it's age related, it means that all the research shows that it is something that happens as human bodies age, in the same way as eyesight and hearing become less good. Bodies start to wear out and the brain is no exception. Additionally, multi infarct dementia is the result of a series of exceedingly small strokes killing off parts of the brain and effecting cognition and memory. I think you would agree that stroke is far more common in older people.
Of course you can think of exception. In the same way, there are exceptions to younger people not developing it, like Terry Pratchett and others who start to suffer from dementia in their 40's.

monkeyspanner

mike88 wrote: »

Thanks for the replies. I shall read the links in detail. In response to Monkeyspanner the Health Board is Cardiff and Vale.

What I meant about no system in Wales is that they seem to be in between two systems and that being the case it may be possible to play one off against the other.

If responsibility is due solely to the Health Board I wonder why my mother's doctor referred me to Social Services and it was they who said they would arrange for an assessment even though they have absolutely no financial involvement.

I think I might ring them again on Monday in order to find out precisely what is going on. Unfortuneately the person I am dealing with does'nt seem to have a clue and keeps referring my questions to a manager. This does not bode well.

The situation in Wales is similar to England prior to the introduction of the new CHC framework and DST in october 2007. The new system in England was designed to provide a consistency of approach across all the PCTs and to remove the postcode lottery of CHC funding. Although the variation of CHC funding has reduced in England there is still a wide variance of success rates across different PCTs and I think it is fair to assume a similar situation exists in the LHBs across Wales.

You may find this anual report from Cardiff LHB dated Sept. 2008 useful for background info. It appears the Cardiff LHB is in dispute with the Local authority regarding who is responsible for funding certain individuals. The key point here is that the LA has to support funding for those people with small financial resources if the NHS does not provide CHC funding so although they should be working together there are inevitable tensions regarding which budget is going to pay.
http://www.wales.nhs.uk/sites3/Documents/262/Annex%20155.pdf

malid

mike88 wrote: »

Thanks for the replies. I shall read the links in detail. In response to Monkeyspanner the Health Board is Cardiff and Vale.

What I meant about no system in Wales is that they seem to be in between two systems and that being the case it may be possible to play one off against the other.

If responsibility is due solely to the Health Board I wonder why my mother's doctor referred me to Social Services and it was they who said they would arrange for an assessment even though they have absolutely no financial involvement.

I think I might ring them again on Monday in order to find out precisely what is going on. Unfortuneately the person I am dealing with does'nt seem to have a clue and keeps referring my questions to a manager. This does not bode well.

This is an extract from Cardiff and Vale minutes of meeting ( http://www.valeofglamorgan.gov.uk/our_council/council/minutes,_agendas__reports/reports/cabinet/2008/08-10-01/nhs_health_care.aspx) which you may find useful:

Background

2. Continuing health care (CHC) is the term used to describe a situation where a person’s health needs are judged to be so significant, complex, severe or unpredictable that they need to be actively managed by the NHS, which will also pay for all the health and personal care they need. Care can be provided in a variety of settings including a nursing home, hospice, the patient’s own home or hospital.

In my view, you need to put pressure on the LHB to instigate the assessment and get Social Services to support you. As a last resort, write to the Health Minsiter - Edwina Hart - and your AM or tell your LHB that this is your next course of action.

margaretclare

I think you would agree that stroke is far more common in older people.

Saying that something is 'far more common in older people' is NOT the same thing as saying that it is a 'normal consequence of the ageing process'.

Cannot you see the difference between those two statements?

Errata

I won't reply further, this is not the thread for discussion about dementia.

greenflamingo_2

Hi all again
We are currently preparing documentation for submission to the SHA.

On looking again through Bury PCT Decision Support Tool we see that my FIL has scored 3 highs, 5 lows and 3 moderates. Is it a done deal that if he scores a certain number of highs he will get funding? Also does it matter on which sections he scores the highs?