Continuing Health Care - Preparing to fight PCT's decision

monday23

thanks moneyspanner.
Thanks. I should add that I have already written to the local MP of my parent , who has forwarded my quetion to the health minister. He did reply more or less saying that there where no guidelines and it was up to the local health board but no help or advice on how to do this. When I contact the health board they don't know what I am talking about. Back to the health minister me thinks! I was just interested if anyone had actually managed to get further than this and what these local health board criteria might be. I am fully aware of the situation in England and feel very confident that they would qualify, even if they didn't at least they would have gone through a process.

monkeyspanner

I hope the MP can make some headway for you. I did find an article that said CHC funding was available in NI but that it was not possible to make retrospective claims. I am not sure if this is the case. Your experience sounds like England used to be prior to the National Framework. It took us 3 months to identify the correct department in the PCT (equivalent of the NI health board ). You could try one of the solicitors that specialise in this area to try to clarify what the NI rules are. If this is of interest PM me and I will send you details of one that has had some success in making CHC claims.

pmrita

Don't know where to put this question to ensure you read it !
I am trying to find information for an elderly aunt in her 80's who lives in Liverpool. She suffers from schizophrenia, has mobility problems,uses a wheelchair if she is taken outside of the house, continence problems etc. She currently has a carer that comes in twice a day for 30 mins am & pm. My aunt lives with her daughter who sometimes has to work away from home for a couple of days a week. In the past a carer has come to the house to stay over for the night. My cousin has been informed that my aunt is entitled to only16 night covers per YEAR anything over that she will have to pay for herself. A major problem is the safety aspect of my aunt and her close neighbours,as she lives in a terraced property and because of her mental condition can turn and leave the gas on, leaving the front door open, letting people in etc. Do you know or can you advise where I can info regarding "her entitlements", have tried the Lpool website without any luck.
My cousin/aunt is having a visit from a Social Worker on Monday to discuss her situation, she last had a visit 2 years ago for the same thing. Would be grateful for help advice or info
Many thanks

monkeyspanner

pmrita wrote: »

Don't know where to put this question to ensure you read it !
I am trying to find information for an elderly aunt in her 80's who lives in Liverpool. She suffers from schizophrenia, has mobility problems,uses a wheelchair if she is taken outside of the house, continence problems etc. She currently has a carer that comes in twice a day for 30 mins am & pm. My aunt lives with her daughter who sometimes has to work away from home for a couple of days a week. In the past a carer has come to the house to stay over for the night. My cousin has been informed that my aunt is entitled to only16 night covers per YEAR anything over that she will have to pay for herself. A major problem is the safety aspect of my aunt and her close neighbours,as she lives in a terraced property and because of her mental condition can turn and leave the gas on, leaving the front door open, letting people in etc. Do you know or can you advise where I can info regarding "her entitlements", have tried the Lpool website without any luck.
My cousin/aunt is having a visit from a Social Worker on Monday to discuss her situation, she last had a visit 2 years ago for the same thing. Would be grateful for help advice or info
Many thanks

Your Aunt is receiving care at home. This care falls under the responsibility of the local council social services. At present there is no national standard of what the council has to provide and what the patients contribution has to be. So your cousin will need to ask the social worker what the local rules are.

From what you have said your Aunt would score highly in a number of categories if assessed for NHS CHC funding but your cousin will need to request a CHC assessment. It is unlikely this assessment will be volunteered and your cousin will be faced with an uphill struggle to acheived funding. there are a number of things I should point out.
- Your cousin should request a CHC assessment when she sees the social worker. It is likely that the social worker will be ill informed as to the workings of CHC funding and assessment and may say that it is not available to your Aunt and your cousin will need to be persitent.
- CHC funding will be administered by the PCT in your Aunts area (if in England) so if the social worker is reluctant to help your Aunt will need to approach the PCT direct.
- Whilst CHC funding is more usually provided in a formal care setting it can be provided in any setting including the patients own home,
- In England the assessment process is formalised across all PCT's. A similar system applies in Wales with the Local Health Boards. There are no formalised national processes in Scotland or N.Ireland.
-The English system starts with a CHC checklist. This should be weighted in the patient's favour so that all that may be eligible will then have a full assessment based on the DST (decision support tool). The DST assesses a number of areas of health.
-Although the assesment process is formalised there are no hard and fast rules about how to decide if a patient is eligible. i.e. what scores on the DST will lead to a successful application.

I hope this helps but if I haven't addressed your concerns please ask again.

pmrita

Monkeyspanner

Many thanks for your quick response.

I did not realise CHC at home could be applied for schizophrenia. My aunt has had this condition probably for 40+ years which is controlled by drugs, I remember as a child my Mum had to have her sectioned into Rainhill Mental Hospital, which must have been horrendous for her.

As a result of your advice, I was successful in obtaining CHC at home for my Mum 5 years ago. She had lung cancer and dementia, which meant for the last 2 years of her life, she could stay comfortable and "happy" in her own home until she died.

I remember well attending a meeting with the GP, Mental Health Nurse, District Nurse, Social Services, PCT and me ! They were trying to reduce my Mums care, but because of you, we won !

Now the next fight begins !

monkeyspanner

pmrita wrote: »

Monkeyspanner

Many thanks for your quick response.

I did not realise CHC at home could be applied for schizophrenia. My aunt has had this condition probably for 40+ years which is controlled by drugs, I remember as a child my Mum had to have her sectioned into Rainhill Mental Hospital, which must have been horrendous for her.

As a result of your advice, I was successful in obtaining CHC at home for my Mum 5 years ago. She had lung cancer and dementia, which meant for the last 2 years of her life, she could stay comfortable and "happy" in her own home until she died.

I remember well attending a meeting with the GP, Mental Health Nurse, District Nurse, Social Services, PCT and me ! They were trying to reduce my Mums care, but because of you, we won !

Now the next fight begins !

It is always good to hear of success. Good luck with your new fight.

pmrita

29-03-2011, 9:03 PM
MoneySaving Convert
Monkeyspanner

I did post a thank you at the time regarding my Mum's care, I hope you did see it

Message of Thanks for Monkeyspanner

I just wanted to send my heart felt thanks to you for the help advice and expertise in CHC you offered during my Mums illness. As a result of this my Mums received CHC for over 2 years whilst in her own home. In fact she only left her beloved home 18 hours before she died in Marie Curies Hospice. I take strength from the knowledge that she is no longer suffering from the horrific lung cancer and dementia which blighted her twilight years.
RIP Mum x

Many thanks

stu1960_2

Hi folks newbie here so please be gentle.
My partner is currently claiming care home fees with a solicitor for her, now deceased, mother.
Its quite complicated but seems to be based on did she need a care home or nursing care.
This is not something we could have fought without professional help, but its costing us 30%.
So my question is,
If my partner is succesful can we claim back solicitors costs from nhs.
If nhs admit they should have been paying the home fees should they not redress us for any costs involved?

monkeyspanner

stu1960 wrote: »

Hi folks newbie here so please be gentle.
My partner is currently claiming care home fees with a solicitor for her, now deceased, mother.
Its quite complicated but seems to be based on did she need a care home or nursing care.
This is not something we could have fought without professional help, but its costing us 30%.
So my question is,
If my partner is succesful can we claim back solicitors costs from nhs.
If nhs admit they should have been paying the home fees should they not redress us for any costs involved?

Sorry to hear of your loss. I assume your partner is making a claim on behalf of the estate.

It sounds like your partner has agreed a conditional fee (no win no fee) arrangement with the solicitor. If successful there will be compensation and solicitors fees paid. But your partner will still be liable for the 30% arrangement as this effectively is the bonus the solicitor has agreed with you to pay them for the risk they take i.e. if they don't win the case for your partner they will not be paid for their effort. This should have been explained by the solicitor when they agreed to take the case. Your partner should however be able to claim your own out of pocket expenses related to the case. These expenses should be discussed with the solicitor if not prompted by them in due course.

The other (more traditional) fee arrangement would be for your partner to agree to pay all fees irrespective of the result of the case this could have put your partner at risk of a solicitors bill of several £000s in the event the claim was lost or the other side would pay if the case was won (if awarded costs as well as compensation). It would then depend on the potential amount of the retrospective claim and the solicitors possible charges whether your partner considered the risk worth taking. Personally I would not risk it as solicitors fees have a habit of running away especially if the solicitor is not paying them!

I hope my assumptions are correct and this helps.Good luck with the case.

realshannon

I am trying to put my claim for CHC to rest but it is sticking in my mind - can I briefly "chuck" this on here and see what the concensus of opinion is please? IN 2010 my v elderly MIL repeatedly fell and eventually hospitalised with broken pubic rami x 2. after a very short period, we had a telephone call from the hospital to say she was being discharged. originally they said she would be going into a rehab unit but this was later retracted for whatever reason. no thorough discharge assessment was undertaken and we had asked for communication thro the family as she had dementia also and was deaf anyway so wouldnt have understood and we wanted to make sure she got the best and correct treatment. we knew nothing of CHC at this stage, like many others. we have obtained the medical notes and the assessment that was done is a joke, it clearly shows she couldnt even make a cup of tea and actually poured the boiling water over the worktop, they said she was confused with her surroundings - the long and short of it is, we couldnt send her home as it wasnt feasible or safe (another long story) and they suggested a residential home, that home couldnt cope with her behaviour and health and she was moved again to another home which coped better but still not that well and she was contstantly under the docs care - meanwhile, social workers got involved and I heard about CHC and wondered why before discharge or just after, she didnt have an assessment. after asking and asking the SW did an assessment, she scored v high but this was overuled by a district nurse as the assessment had been done with the SW on her own. they redid it and she did not score highly. we appealled, the sheet was done again, low score. MIL's health was deteriorating rapidly and we noticed she kept falling even within the home, we continued to ask for more assistance and eventually she was rushed into hospital again with internal bleeding, we then insisted before she was discharged again she had a CHC done properly. this didnt happen but they did arrange to send her to a more suitable nursing home where, when she was a little bit more stable, we had an assessment done. out of the dates suggested where everyone could attend, when we got there, only one person attended. the end of which was that he agreed she could have nursing care element. within 2 weeks she had died from internal bleeding, heart failure and dementia at 91. Now, having started a complaints procedure and got nowhere with the hospital, do I pursue that for the CHC or do I pursue a negligence case? or is it both. I feel the SW and DNs were all negligent and I still cant believe that when she was discharged from hospital so promptly that no proper assessment or care package had been put in place, regardless of going into a small residential home. we have paid for everything apart from the last nursing home, this was funded under another scheme. surely this proves the point that she needed nursing care from the beginning? I am biased of course but what does everyone else think? I want to put this to rest but it is niggling me and it isnt to do with the money. I tried Hugh James who were v helpful but they felt because we had already had several assessments albeit incorrectly done, they didnt want to get involved for a no win no fee basis - help or suggestions all gratefully received please, thank you