Continuing Health Care - Preparing to fight PCT's decision

EdInvestor

http://www.telegraph.co.uk/finance/personalfinance/insurance/longtermcare/6554702/Long-term-care-still-a-postcode-lottery.html

Someone who has successfully fought the CHC system has now set up a company to help others doing the same.

Zebra

Following on from this thread that I posted a couple of weeks ago, and some great advice from Monkeyspanner, I thought I'd post on this thread.

Basically, my father has had a stroke and is currently in hospital.
We have had a meeting with social services and they will be doing an CHC checklist shortly and then a full assessment by the PCT to follow.

What action should we be taking now prior to the assessment?

Social services have said we can have a copy of the checklist, but ideally we would like to be present when it's been carried out.

cohentb

monkeyspanner wrote: »

Thanks CHC for the comprehensive reply.

Could I pick up on one point? In the 2 PCT IRP's (spring and summer of 2008) that were held in my MIL's case the emphasis was almost entirely reviewing the medical evidence and decision based on the DST. The lay chair was very reluctant to discuss adherence to process by the PCT even though we wanted to raise several points of non-adherence at that time.

Although not relevant now as we obtained retrospetive NHS CHC funding, I assume from what you have written that the PCT's IRP process we experienced was also not adhering to the National framework.

We had exactly the same problem. We had the documentation that showed procedure had not been followed by the PCT. The panel chair advised us not to present this as it would make no differencr. We got the CHC funding but the PCT continues to deny any maladministration by them, hence no recompense for the costs of the seven year fight and no apology. The Ombudsman has said it would have to be a new case , even though they had noted the PCT failure in their 1st ruling.
So here we go for another couple of years!

Katykat

Anyone have any idea how long the decision is likely to take? Mum had CHC assesment on 19/11, not heard anything yet. Or am I being totally unrealistic to expect a quick decision

CHCscandal

Katykat wrote: »

Anyone have any idea how long the decision is likely to take? Mum had CHC assesment on 19/11, not heard anything yet. Or am I being totally unrealistic to expect a quick decision

Hi Katykat, when your mum had CHC assessment was it a full, multi disciplinary Team Assessment?
Were the DST domains worked through properly in a timely manner with full input from all?

If so, then the result should been obvious at the end of this meeting.

The new framework it quite clear that the MDT outcome is the decision maker, any further panels from that point should merely ratify the outcome which is not a decision to be made unilaterally after the meeting, did this happen?

The whole process is supposed to be transparent and totally equitable with you informed throughout of timescales.

After the MDT, the result is then sent to the PCT panel, who are not a gatekeeping function, supposedly, who merely should ratify the outcome determined by the MDT, but these panels are used as a gatekeeping function and the majority of processes in place use this as a faceless way of communicating decisions seemingly sometimes quite some time after the MDT.

The process is supposed to be 14 days, as the PCT hold these scrutiny meetings once aweek or fortnightly, what was the outcoem of the DST/MDT how many priority/severe/high marks etc were collated?

Katykat

CHC- I've just looked back at one of my posts to check mums score & I wrote at that time that the decision would be 3-4 weks, so they must have told me that at the time, so thats why I've not heard yet. about your post. She scored 1 severe, 4 high, 1 moderate & the rest were low & 2 no needs. We were given absolutely no indication of how it would go. In fact when I asked outright, the PCT guy told me it wasn't his decision, it had to go to "the panel". It was a full MDT, including social worker, PCT, care home manager myself & brother. I did feel it was conducted fairly, although I am fully expecting a refusal in the first instance

Katykat

Well, got the letter today, & as expected, the funding has been refused. I'm going to discuss with my brother, but we had decided pre decision that we would challenge it. However, for personal reasons I am not going to do it myself. I'm putting it into a specialists hands. I have already done some research & found a company that charges a fixed amount of £595. I dont feel that this is extortionate for the work involved but obviously I am fuming that this should have to happen at all. Shame on all the PCT's & the Government who, even though they drew up the National Framework, they know that the PCT's are working their own agenda & they are doing absolutely NOTHING about it. I like to think I'm not a vindictive person, but believe me I am now. If any MP or even PM ends up with dementia, will they receive my sympathy??? I think not!!!!!

Trebor16

I personally believe that the PCT's are using their old pre National Framework criteria to carry out the assessments and they simply write it up to make it look as if they have complied with the National Framework and the DST. I believe that is what has happened with my father, who had been funded by the NHS for two years but they have reassessed him and decided that he no longer has primary health needs and his needs are predominantly for social care.

He must be one of the first people with vascular dementia who has actually improved!

ct888

Hi Monkey Spanner

I have found your comments and advice most helpful but wish to find a solicitor in England on a no win no fee basis and you mentioned you knew of some. I would much appreciate if you could let me have details? CT888

Trebor16

ct888,

You might find this link useful:-

http://freenursingcare.findtalk.net/forum.htm

Steve Squires is the gent who runs it and he has been campaigning for a number of years. If you sign up to the board there is a solicitor recommended by Steve and he will pass on the details.

(It's a free forum and there is no catch to signing up)