Continuing Health Care - Preparing to fight PCT's decision

monkeyspanner

Hi Les
Looks like they are confusing themselves by not using the right terminology for each action. So
Positive Checklist
Negative DST
Review in 3 months

Would agree with CHC I don't think they followed proceedure as the DST is supposed to be completed by a multidisciplinary team.

Your next step I think is object to the negative decision based on the DST and ask for a PCT independant review panel. If that fails ask the SHA to look at how the PCT conducted the assessment and review (PCTs don't like it when the SHA get invovled as inevitably they get told they didn't follow proceedure). Essentially it sounds like the medical problems were downplayed in order to achieve a negative decision which is pretty standard practice I believe.

oldguy_2

My understanding is that the Decision Support Tool and the associated recommendation should be completed by Multi Disciplined Team not one person as seems to be the case here.

The decision of the MDT can then be reviewed by a panel with a quality control function to ensure quality and consistency. They seem to be suggesting that this panel consists of one person. Section 80 of the national Framework says;-

Many PCTs use a panel to ensure consistency and quality of decision making. However, a panel should not fulfil a gate-keeping function, and nor should it be used as a financial monitor. Only in exceptional circumstances, and for clearly articulated reasons, should the multidisciplinary team’s recommendation not be followed. A decision not to accept the recommendation should never be made by one person acting unilaterally.

(my underlining)
The reliance on a series of people acting alone seems to be in contradiction of the guidelines.

• One person acting alone completed the Checklist which decided a full CHC assessment was needed
• The same person acting alone completed the DST and made a recommendation for CHC funding
• Another person acting alone reviewed the DST and recommendation and decided not to accept it.

Les_Booth

There was another person present from the N.H who he said had nursing & social skills. Would the two have them constituted a MDT ?

Les_Booth

btw - can you help a newbie with some of the acronyms please ?
IRP
SHA

oldguy_2

Les_Booth wrote: »

There was another person present from the N.H who he said had nursing & social skills. Would the two have them constituted a MDT ?

I don't know. Did he or she sign the Decision Support Tool and recommendation?

Les_Booth

Her signature and his appear in the last box of the DST "Names and signature of the team" along with the signature of the Senior Practitioner (not present at assessment) but who confirmed PCT decision not to fund

monkeyspanner

Les_Booth wrote: »

btw - can you help a newbie with some of the acronyms please ?
IRP
SHA

Sorry
IRP - Independant Review Panel
SHA - Strategic Health Authority

Katykat

Les, my understanding of the MDT is- a representative of the care home, a representative of the PCT & a representative of the Local Authority, usually a Social Worker. This may be Patricks regular social worker, or in my experience, a complete newbie, because they are always changing posts. This team should also include a respresentaive of the patient. Note I said Patient, not client, as I fully believe that these people we are talking about are patients & as such should be cared for by the NHS. I am eagerly awaiting our decision, although I can guess the outcome. I've already started preparing my appeal.

Les_Booth

The social worker did not attend as she was not invited. I queried this with the assessor - who said "...........they post the visits on the board and they have the opportunity to attend if they wish........"

Katykat

Les, I really think Patricks interests have been neglected here. I'm sure it is a requisit that the social worker has to attend, not just "if they feel like it". It seems to me that you have good grounds for appeal, not just on the decision but that the regulations have not been adhered to.