Continuing Health Care - Preparing to fight PCT's decision

monkeyspanner

As long as your mum is not saying I don't want to go home with you and is prepared to discharge herself from hospital you should be ok. The only exception to that would be I notice the hospital do not think your mum is mentally capable whereas reading between the lines I think you believe she is capable. If they do not think she is capable they could overide your wishes and your mum's expressed wishes on the basis that she is acting contrary to her best interests. There have been cases were a legal hearing has been required to break the deadlock. Equally they would I think have difficulty forcing her into a care home and this would be contrary to normal practice. However something similar could be acheived under a temporary section of 28days duration under the mental health act but this would not be in a care home setting.

Do not let them bully you. Your mum is the primary concern here. If you feel intinidated you should say you feel you are being coerced and that you insist that is recorded in any notes of any meeting. It is difficult to be assertive in these circumstances but they won't want it in the records and it may help you to maintain some control.

Please consider, however, that unless you can keep them onside to some degree you are unlikely to get much co-operation or help from them in the future and from personal experience they can be a vindictive bunch.

The CHC checklist is the first stage in the NHS Continuig Healthcare funding award process this funding is non-means tested and will pick up the total care costs but is very difficult to obtain. The award of CHC funding will only be made if the patients primary need is medical rather than domestic. If this sounds a bit vague and open to interpretation that is because it is and as a result there are large variations in award rates across the country. The checklist is an initial screening that is designed to determine if a full CHC assessment is required. Preferably it should be carried out by someone who is medically qualified but it can be carried out by others.

angie1965

could i get an advocate to act on mams behalf

realshannon

it really does seem common practice - as this is not so dissimiliar to my tale. I totally agree about reading all of this blog, I did it in a few stages but it made me feel better for one. I have just spoken to the solicitor who did the enduring power of attorney in 2004 but she says now MIL is unable to decide on her affairs, it needs registering with the court of protection and has quoted £500. As nice as she was, I did think, it cant be that difficult - have seen the site above public guardian and it is a very small family so, is it really easy peasy? she would probably also qualify for the fee exemption. still waiting for the results of the last ridiculous checklist that should have been an assessment, before I put the appeal in. give it till next week, if not I will complain as suggested but want to see how they marked her etc

monkeyspanner

If it is an EPA and MIL is now not mentally competent the EPA should be registered. I would have a look to see how complex the registration process is to carry out yourself.

Savvy_Sue

I'm sure if you phone the OPG they will be helpful, but having a read of the process on their site will give you some idea.

tubsmacker

Angie, Fully funded CHC is available at Home and you should demand a full assessment for it prior to discharge. If you agree to discharge to a private facility then your mum will lose her house. The problem is that CHC at home costs more than a Nursing Home so they don't like paying. Tell them you demand an assessment for fully Funded CHC and that you insist she stays in hospital until she is properly assessed. Don't sign anything either.


As for POA, it is easy to do yourself direct with the OPG. Paying a solicitor to do it is a waste of money.

angie1965

I was informed mam has no medical reason to be kept in hospital but they assure me she needs 2 carers and 24 hr care which i totally disagree with........i assume this assessment is in relation to continuation of care and if thats so she isnt entitled to it bcos she has no need of a nurse to care for her:)

hortibob

Like others I have read through this thread with great admiration for the enduring strength and the excellent information provided by the contributors, and I must say that I too am appalled by the lies, secrecy and miss-information surrounding this issue.

It is all further confused by the fact that I live in Scotland and relevant law and regulations are not easy to find, indeed, this has been by far the best source for supportive information for my family as we attempt to ensure our father is not "mugged" by the system. However we are still missing a full understanding of how NHS CHCs are SUPPOSED to be conducted in Scotland.

We have been told by my fathers GP that he's never heard of NHS CHC, by my fathers care manager that it doesn't exist, by his district nurse that she's never heard of it.

Could some kind person please confirm for us that fully funded NHS CHC IS available in Scotland and suggest where we might find the relevant documents/law/regulations.

Many thanks

Bob

malid

monkeyspanner wrote: »

If it is an EPA and MIL is now not mentally competent the EPA should be registered. I would have a look to see how complex the registration process is to carry out yourself.

Angie 1965, it is straightforward to register the EPA. Make sure you have completed the form correctly (again, the guidance is straightforward); then, following the guidance, post the form with the relevant cheque to the OPG in London. It will cost you much more to go to a solicitor and there is no need. It is not complicated; like all forms, you just need to cheque that you have filled in all the boxes correctly - maybe get a friend/colleague to double check if you're a bit nervous.

monkeyspanner

hortibob wrote: »

Like others I have read through this thread with great admiration for the enduring strength and the excellent information provided by the contributors, and I must say that I too am appalled by the lies, secrecy and miss-information surrounding this issue.

It is all further confused by the fact that I live in Scotland and relevant law and regulations are not easy to find, indeed, this has been by far the best source for supportive information for my family as we attempt to ensure our father is not "mugged" by the system. However we are still missing a full understanding of how NHS CHCs are SUPPOSED to be conducted in Scotland.

We have been told by my fathers GP that he's never heard of NHS CHC, by my fathers care manager that it doesn't exist, by his district nurse that she's never heard of it.

Could some kind person please confirm for us that fully funded NHS CHC IS available in Scotland and suggest where we might find the relevant documents/law/regulations.

Many thanks

Bob

Yes CHC funding is available in Scotland and Wales as well as England. Due to the devolution of powers to the Scotish and Welsh Assembly Governments responsibility for healthcare has been devolved. As a result Scotland and Wales have not followed the modified system of assessment introduced in England in October 2007 and have or are in the process of inventing their own systems. Such is the idiocy of devolution IMHO. It does not surprise me that the health "professionals" you have asked have not heard of CHC or are denying knowledge of it. The NHS do not want to pay for this care and will do practically anything to avoid doing what the courts have decided is their responsibility. It is probably no consolation but it took us 3 months to find out who ran CHC assessment services in my MIL's local PCT in England and much longer to work out how the system was supposed to function. Rant over now for some information.

This fact sheet gives you a very brief introduction.
http://www.counselandcare.org.uk/category/advice/pdf/continuing-healthcare-should-the-nhs-be-paying-for-your-care-guide-27

The Scottish guidelines published in Feb 2008 are here
http://www.sehd.scot.nhs.uk/mels/cel2008_06.pdf
I have quickly read through this document. There seems to be much more emphasis on clincal inpatient settings as a function of eligeability than in the English National Framework. Although this is then contradicted in another part of the document where any care setting is proposed as acceptable. The document reminds me of the CHC guidance in England prior to the 2007 framework where the clinical emphasis was largely discarded in favour of any setting with any combination of carers. There is of course the element of state funded nursing care in Scotland and joint funding of domestic and nursing care which I have to admit I don't fully understand. But in a way this leaves CHC more for the most severe cases. Possibly some patients who might be CHC funded in England would not be in Scotland as part of their care costs are already covered. Has anyone had practical experience of how the CHC functions in Scotland?

you can also try Age Scotland for advice
http://olderpeoplescotland.org.uk/home.html

I hope there is something here that will assist. I am not familiar with the detail of the Scottish system but essentially the system is underpinned by the same case law as in England and Wales.

In the first fact sheet you will find a link to assessment services document which you will find does not work as counsel and care have reorganised their website try this link below
http://www.counselandcare.org.uk/category/advice/pdf/assessment-and-services-from-your-local-council-in-scotland-guide-50

You might find this factsheet regarding hospital discharge in Scotland useful
http://www.counselandcare.org.uk/category/advice/pdf/hospital-discharge-in-scotland-guide-51