Continuing Health Care - Preparing to fight PCT's decision

monkeyspanner

robv wrote: »

got confirmation today we have qualified for CHC.

The appeal to the original decision was put on hold waiting for the results of latest application triggered by the appeal. Was advised to wait at every stage otherwise you may get passed back to the original PCT saying they did not get a chance to fully investigate.

Thanks for sharing your good news with us and well done.

laine2306

Hi everyone,

My dad was living with me and my then 10 year old daughter until December 2008. Dad was having carers visit him 4 times a day but then had another TIA and was hospitalised. The social worker then decided that dad could not return home as they could not supply any more assistance than the 4 calls a day. No CHC was done. Dad had not been having to pay anything towards the carers coming to visit him at home. Suddenly I received a form to complete in respect of his financial situation. I duly completed it on dads behalf. I later found out that I should not have done because of the DPA. I then received details of what dads contribution would be. Dad had been awarded the extra funds for the nursing care element. I did commence making the payments on behalf of dad. I then found out that dad should be entitled to have all his care paid for for him and I was advised to stop payments immediately. Now 2 years later my local council are trying to get the POA revoked so that they can become deputy basically so that they can pay themselves the money they feel is due. A CHC was done and the result was negative. My dad has prostate cancer, dementia, has to be fed and is doubly incontinent. Under the 1946 National Health Act it clearly states that if someone has a "health need" then all their care should be "free at the point of need". This battle has been ongoing. It appears that I am the only person who feels that dad has a "health need". No Act has been passed through Parliament stating that the CHC is legal to use. I myself am on benefits and I have managed to get a solicitor through legal aid but she has said she will only act for me if I agree to pay what other people say is due. It is an absolute nightmare and I am at the end of my tether especially as I also now have my daughter who has entered the terrible teens. I had an advocate who was acting on my behalf but it appears now that he has not even appealed the decision of CHC. Any ideas about what I should now do would be greatly appreciated.

Savvy_Sue

liane, welcome to the boards, and welcome to the struggle.

I'm not sure how best to advise you, beyond starting on page one of this thread and making notes as you go (I'd be copying and pasting things into a Word document!) on other links to look at, what other people have done in a similar situation etc.

Hopefully someone else with more experience will comment on your particular difficulties.

monkeyspanner

Sorry to hear of your difficulties. Thanks for your post. I hope the following comments will be useful and if I have at any point made incorrect assumptions please let me know.

The most important thing is to try to avoid the Council's SS from gaining control of your dad's finances. If this happens you will be cut out of the process and effectively have to accept their decisions.

So I think the solicitor who has offered to act for you is correct, you need to bring payments up to date if you can in line with decisions made to date. However, all is not lost! You may well be able to claim for backdated (retrospective) repayments if you can achieve a CHC award. The council's SS department are not the decision makers as CHC funding is awarded by the PCT (pimary care trust) on behalf of the NHS. So potentially the SS will benefit if CHC funding is awarded so I know it is a long shot but try to get the SS on your side they may support a CHC claim.

On the practical side is this solicitor a specialist in this area? This is a complex area and it will help if they have dealt wit CHC awards in the past. But in any case if you can get free legal assistance you should accept it if you can.

I assume that your dad is now in a care home and is self funding and that this is the source of your disagreement with the SS. In reality this is not their fault (other than they have probably not given any assistance in your claim for CHC funding) and they are having to act within the funding rules. So you need to retrace the steps with the PCT CHC assessment team. If your dad was discharged from hospital to a care home in England after Oct 2007 then a minimum requirement was that an initial CHC checklist should have been carried out. If this checklist was favourable a full CHC assessment using a DST should have been carried out. If this process was not followed then you can complain to the relevant SHA (strategic health authority) but they can only review the process not the CHC decision itself. You should however approach the PCT CHC assessment team state you are not satisfied with the previous decision and give reasons for you dissatisfaction and request a new assessment ASAP particularly if it is some time since the last assessment. You should also make it clear you wish to be your relatives adsvocate at the assessments so that you can put your view on the medical situation.

Good luck. Please feel free to correct any incorrect assumptions and ask questions either on the forum or by PM.

Trebor16

laine2306 wrote: »

Hi everyone,

My dad was living with me and my then 10 year old daughter until December 2008. Dad was having carers visit him 4 times a day but then had another TIA and was hospitalised. The social worker then decided that dad could not return home as they could not supply any more assistance than the 4 calls a day. No CHC was done. Dad had not been having to pay anything towards the carers coming to visit him at home. Suddenly I received a form to complete in respect of his financial situation. I duly completed it on dads behalf. I later found out that I should not have done because of the DPA. I then received details of what dads contribution would be. Dad had been awarded the extra funds for the nursing care element. I did commence making the payments on behalf of dad. I then found out that dad should be entitled to have all his care paid for for him and I was advised to stop payments immediately. Now 2 years later my local council are trying to get the POA revoked so that they can become deputy basically so that they can pay themselves the money they feel is due. A CHC was done and the result was negative. My dad has prostate cancer, dementia, has to be fed and is doubly incontinent. Under the 1946 National Health Act it clearly states that if someone has a "health need" then all their care should be "free at the point of need". This battle has been ongoing. It appears that I am the only person who feels that dad has a "health need". No Act has been passed through Parliament stating that the CHC is legal to use. I myself am on benefits and I have managed to get a solicitor through legal aid but she has said she will only act for me if I agree to pay what other people say is due. It is an absolute nightmare and I am at the end of my tether especially as I also now have my daughter who has entered the terrible teens. I had an advocate who was acting on my behalf but it appears now that he has not even appealed the decision of CHC. Any ideas about what I should now do would be greatly appreciated.

Hello Laine,

Has the local authority complained to the Office of the Public Guardian about you? It seems to be a more commonly used ploy by local authorities whenever anyone stands up to them. I am in the same position, where my father was funded for 2 years by the NHS and then they said his needs were no longer health needs. The local authority stepped in and started to pay the bills and then invoiced me. I sent them back, stated the debt was in dispute and told them to take it up with the NHS.

They have now complained to the OPG.

The OPG are a law unto themselves and try all sorts of tricks. I managed to see the local authority complaint and it was full of inaccuracies but the OPG don't care about this.

So it looks like I will be off to the Court of Protection at some time in the future.

The system is sadly corrupt and is being abused by the local authorities. The OPG is complicit in this abuse. It's a rough ride but I am not giving in to a system that is geared up to robbing the elderly of what they have worked hard for to pay for care which the NHS should legally be providing.

ianua1

For those worried that loved ones who are having a CHC assesment won't be eligible, when the time comes, respnd to the NHS with the following,

"We will not accept rejection of our claim for continuing care which is based on 'eligibility criteria which is not 'Coughlan Compliant' and we hereby give you notice that we intend to appeal to the Ombudsman upon further rejection. We will also seek legal advice on serving your authority with a mandatory order to comply with their statutory duty under the National Health Servce Act and the Appeal Court's 'Coughlan' Judgement. We will also seek redress under the Article 6. of the Human Rights Act."

And remember.....

Clinicians cannot make quasi-judicial decisions because the right to care is a matter of law - not medical opinion and any 'nurse assessor' making such a decision would be in breach of Article 6 of the Human Rights Act and open to prosecution and liable for exemplary damages.

ianua1

http://www.gpss.force9.co.uk/nhscare/inpress.htm

ianua1

https://www.NHSCare.info

roughyedz

Trebor16 wrote: »

Hello Laine,

Has the local authority complained to the Office of the Public Guardian about you? It seems to be a more commonly used ploy by local authorities whenever anyone stands up to them. I am in the same position, where my father was funded for 2 years by the NHS and then they said his needs were no longer health needs. The local authority stepped in and started to pay the bills and then invoiced me. I sent them back, stated the debt was in dispute and told them to take it up with the NHS.

They have now complained to the OPG.

The OPG are a law unto themselves and try all sorts of tricks. I managed to see the local authority complaint and it was full of inaccuracies but the OPG don't care about this.

So it looks like I will be off to the Court of Protection at some time in the future.

The system is sadly corrupt and is being abused by the local authorities. The OPG is complicit in this abuse. It's a rough ride but I am not giving in to a system that is geared up to robbing the elderly of what they have worked hard for to pay for care which the NHS should legally be providing.

Dont be put off applying to the Court Of Protection , in fact do it as soon as possible as although they say it can be done in 3 months it took me 11 months thanks to the obstructions of my local authority and also the incompetence of the OPG ... My local M.B.C. put all sorts in my way of progress....however after looking at the OPG web site which actually said itself that it could cost up to £2,000 to get a Deputy Order, .........I did it all myself and it only cost a grand total of £80 .... and that was for an insurance policy ....as they think everyone is going to run off with money ....lol .... although I do actually understand the need for this ...

Apply straight away ..................

ajd1301

hi there, my father has been in a carehome for the last year paying 2,000 a month. he was diagnosed as suffering with early stages of cenile dimentia. if i have read the thread correctly, he may have been assessed incorrectly. is this correct.

if so, how can I attempt to get the money he has spent back and prove he was assessed wrong. because his money is now down to the 21k threshold they have picked up the tab.

is this correct. if so how do i start claiming it back or attempt to .

help!!!!!

regards ajd1301