Continuing Health Care - Preparing to fight PCT's decision

Katykat

You are in the right Tubsmacker. fortunately for you, you "discovered" all this before you ( or your relative) started paying. I am one of the unfortunate who knew nothing about CHC and belived all the lies ( from Social services) that "care" had to be paid for if you had money. I am continuing my fight. The BIG lesson I have learned though is this --- I am going to spend any moneyI have whilst I am able bodied. There WILL BE NO MONEY IN MY BANK ACCOUNT if I ever have to be means tested.

Primrose

monkeyspanner - well done for your persistence in pursuing what must have been a very stressful procedure when you were trying to cope with your M-I-L. The example you've given, sadly, seems to be all too frequent in the NHS. I fought a battle for almost 8 years with the Primary Care Trust concerned after my dear father had been sectioned under the Mental Health Act with dimentia and had to go into care. Not a single social worker or individual in the NHS at any time advised me that he was entitled to free residential home care or any kind of assessment and I had to sell my parents' home to fund his fees. It was only after a major campaign appeared in the press long after his death that I realised. It took me a three year battle and a file of correspondence about a foot thick before the PCT backed down and refunded his fees. It's just so sad that at times of major stress like this that patients and relatives received such poor support. And whatever is said about ringfencing funds in the NHS, I can only fear it will get worse.

monkeyspanner

For anyone in Wales here are the links for the Welsh CHC framework and DST implememted in August.

http://wales.gov.uk/topics/health/publications/health/ministerial/letter01810/;jsessionid=rlSKMQnNQw9Q49vnQ8DmBTphnHL7Ttl62jdngyyv58n0QJ4WhV1M!179347272?lang=en

Bakewell54

Tubsmacker I am glad to hear someone so determined.
We are in an unusual position, not paying for care, but are constantly under pressure from assessment procedures and disguised threats. But still the 'dragging on' applies to us too.

I liken the NHS clerical staff to gangsters and, like all of you (almost), have the utmost distaste for them. How they sleep at night is beyond me.

My mother was first assessed under the 2007 framework. Her impending assessment is to be under 2009 framework. I have disputed this, but they insist. How can you compare someone assessed under 'apples and oranges' with 'pears and bananas' ?
I am convinced that they insist because they know I am familiar with 07, but not with 09.

Sadly, my mother now has cancer and I am at aloss as to how this will impact upon the assessment, if at all. Anyone??

Fight on everyone, it is a lonely path, but a right one.
xx

monkeyspanner

Bakewell54 wrote: »

Tubsmacker I am glad to hear someone so determined.
We are in an unusual position, not paying for care, but are constantly under pressure from assessment procedures and disguised threats. But still the 'dragging on' applies to us too.

I liken the NHS clerical staff to gangsters and, like all of you (almost), have the utmost distaste for them. How they sleep at night is beyond me.

My mother was first assessed under the 2007 framework. Her impending assessment is to be under 2009 framework. I have disputed this, but they insist. How can you compare someone assessed under 'apples and oranges' with 'pears and bananas' ?
I am convinced that they insist because they know I am familiar with 07, but not with 09.

Sadly, my mother now has cancer and I am at aloss as to how this will impact upon the assessment, if at all. Anyone??

Fight on everyone, it is a lonely path, but a right one.
xx

In the brave new world that is the UK if the results are not as desired then the rules are changed.

If your mother's worsening medical condition affects any of the assessment criteria of the DST then this could impact favourably on the results. Under the 2007 framework funding could not be withdrawn if a new assessment refused funding until the appeals process had been completed. I believe this is no longer the case and therefore if a new assessment refuses funding you may be faced with having to find funding whilst fighting the decision.

I am not sure what your mother's prognosis is but she may be eligable for fast track funding if her condition is deteriorating rapidly. Although this is not really relevant unless funding is withdrawn.

I hope things are ok and your mother has the sympathetic assessment she deserves.

Errata

Clear info on CHC Decision Support Tool and the Fast Track Tool here http://www.sheffield.nhs.uk/chcfnc/apply.php

Energise

I've found it very interesting to read the previous posts as now in similar situation regarding my mother (86 yrs) currently in hospital after a further series of TIA's/mini strokes, hence vascular dementia and mobility deteriorating, now requiring residential, possibly nursing, home care.

She is currently on Section 117, which I have been told is due to be rescinded next month at a '117 meeting', but will obviously fight if that is the decision as she is obviously still needing care. However, the alternative will be Continuing Care but have been told it would be reviewed after 3 months and only continued if her condition had further deteriorated, not if if remained the same.

I don't understand their logic except to assume they just don't want to pay out.

My father has, just last week, moved into Residential care, as not feasible to live alone, with carers calling in a few times a day (most unsatisfactory for his situation - disabled with arthritis, cancer and depression, and the rest!) so that will leave property that will presumably have to be sold.

I find the whole situation regarding funding is a nightmare and, as previously mentioned, no-one tells you what your entitlements etc are - you just have to find out yourself, sometimes seemingly too late.

So, I will be keeping in touch with this forum, and will post how I get on, on behalf of my parents.

Thanks for all of you who contribute such good information/web links etc. Very helpful

Katykat

Energise, you will also find lots of help and support on the free nursing care forum ---- http://freenursingcare.findtalk.net/general-chat
Incidently i,like you, had a relative sectioned under section 117. I was under the (wrong) impression that she would be automatically entitiled to free aftercare. However, the description is blatantly vague, --ie
Aftercare under section 117 must be provided free of charge.
In 2002, the House of Lords held that this section imposes a freestanding duty to provide aftercare services and not simply a gateway to other community care services. As there is no express power to charge for services provided under it, such services must be provided free of charge.
All aftercare services must therefore be funded by the relevant Health Authority, Primary Care Trust or local social services authority. If someone chooses to make private arrangements for care, either in addition to or instead of, aftercare that should have been provided, it may be possible to claim repayment for this on the basis that the authority had failed to discharge their duties under section 117. However, the authority or the court would be entitled to consider the reasonableness of the private arrangements and the level of reimbursement appropriate.
You'll notice that I've outined the term "local social services authority". What it means is that if you local PCT deems that you have a Primary Health need, then indeed the care will be free, because its provided by the NHS. However, if they deem that you DONt have a primaryh health need, then the aftercare is provided by the local authority, and this is means tested, so if you have over £23500 in assests 9 including your house), then you have to pay. The truth is, very few people are deemed to have a primary health need without a very long fight ( & of course someone to fight that battle for you). So, even though section 117 SAYS that aftercare is free, it isn't free for everyone. Only people sectioned under section 2 will get free NHS care.

monkeyspanner

Energise wrote: »

I've found it very interesting to read the previous posts as now in similar situation regarding my mother (86 yrs) currently in hospital after a further series of TIA's/mini strokes, hence vascular dementia and mobility deteriorating, now requiring residential, possibly nursing, home care.

She is currently on Section 117, which I have been told is due to be rescinded next month at a '117 meeting', but will obviously fight if that is the decision as she is obviously still needing care. However, the alternative will be Continuing Care but have been told it would be reviewed after 3 months and only continued if her condition had further deteriorated, not if if remained the same.

I don't understand their logic except to assume they just don't want to pay out.

My father has, just last week, moved into Residential care, as not feasible to live alone, with carers calling in a few times a day (most unsatisfactory for his situation - disabled with arthritis, cancer and depression, and the rest!) so that will leave property that will presumably have to be sold.

I find the whole situation regarding funding is a nightmare and, as previously mentioned, no-one tells you what your entitlements etc are - you just have to find out yourself, sometimes seemingly too late.

So, I will be keeping in touch with this forum, and will post how I get on, on behalf of my parents.

Thanks for all of you who contribute such good information/web links etc. Very helpful

Sorry to hear of your parents illnesses it must be difficult for you having to deal with both their situations and provide support for them.

As you say you are never given the information you have to find it yourself. A couple of things spring to mind regarding the information you have given regarding your parents.

It sounds like both your parents will need residential care. As you say this leaves the house available for funding care.

If the intention is to sell the house it is possible to apply for a 12 week disregard period during which the value of the house will be disregarded from any financial assessment. This is only relevant if the value of either parents savings (other than the house) are below the minimum savings level of around £23000 and their income is too low to cover the cost of the care. Alternatively you can request that the council pay the fees and place a financial charge over the house until it is sold. The advantage of this is that no interest is charged on the deferred fees until the house owner dies. It may also allow you parents to get lower fee arrangements with the care home if the Social Services organise the care home placement and contract.

If either of your parents is still officially living in the house or certain classes of dependant relative live in the house, then its value should be disregarded.

If a patient's medical condition is considered terminal ten it may be possible to obtain CHC under the fast track assessment system.

I would recommend www.counselandcare.org.uk as a good source of information and they also operate a help line.

I hope you manage to find your way through the system.

Bakewell54

monkeyspanner wrote: »

In the brave new world that is the UK if the results are not as desired then the rules are changed.

If your mother's worsening medical condition affects any of the assessment criteria of the DST then this could impact favourably on the results. Under the 2007 framework funding could not be withdrawn if a new assessment refused funding until the appeals process had been completed. I believe this is no longer the case and therefore if a new assessment refuses funding you may be faced with having to find funding whilst fighting the decision.

I am not sure what your mother's prognosis is but she may be eligable for fast track funding if her condition is deteriorating rapidly. Although this is not really relevant unless funding is withdrawn.

I hope things are ok and your mother has the sympathetic assessment she deserves.

Oh you were so right and thanks a MILLION :beer: for getting me on my toes. You saved us from a serious mistake. Can't say to much as am sure they readthis! But thanks so much ....xx:A