Continuing Health Care - Preparing to fight PCT's decision

in Over 50s Money Saving
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  • edited 20 August 2012 at 6:23PM
    margaretclaremargaretclare Forumite
    10.8K Posts
    edited 20 August 2012 at 6:23PM
    All I can comment on here is the fact that I had a fractured pubic ramus (the narrow bit of the pelvis that joins in front - 1 ramus, 2 rami). I tripped on a granite sett outside a petrol station, about 5 years ago now, fell backwards with a bang and that was what happened. It was extremely painful, but after 8 weeks on crutches it healed and no long-term effects. But then, I'm not 91 with dementia.

    This poor woman probably didn't understand what had happened to her and would have been in extreme pain. I used crutches to avoid weight-bearing but she probably couldn't do that, couldn't understand and couldn't co-operate.

    BTW I wasn't hospitalised - went to A&E, the fracture could be clearly-seen on X-ray. I saw a rehab person who offered me help at home, someone to come in and get me up, put me to bed etc. I'd have had to pay for it, but in fact I didn't need it. So long as I avoided weight-bearing it was painful but it was fine. But, trying to walk without crutches, that would have been extremely painful and unstable - no wonder there was repeated falling! Yes, she should have had rehab, teach her to walk using crutches, avoiding weight-bearing, but OTOH maybe it was thought that she wouldn't take all this in, couldn't learn. Impossible to say.
    [FONT=Times New Roman, serif]Æ[/FONT]r ic wisdom funde, [FONT=Times New Roman, serif]æ[/FONT]r wear[FONT=Times New Roman, serif]ð[/FONT] ic eald.
    Before I found wisdom, I became old.
  • Hi Realshannon
    Sorry to hear of the NHS shambles your late MIL had to suffer.

    I will assume your MIL was resident and received hospital care in England. (Rules for Wales Scotland and N.I. are different)

    I am not 100% sure where you are with your dealings with the local PCT. If you have not exhausted their appeals proceedure you will need to apply to their CHC assessment department for a retrospective review and IRP (independant review panel) to assess your MIL's case.

    If the PCT review process has been exhausted you can apply to the SHA (Strategic Health Authority) for a review of how the CHC process has been managed by the PCT. The SHA can only look at the way the process has been handled not the actual CHC decision. I am tempted to say that on the face of it the process has been so badly handled that you could approach the SHA in parallel with asking for an IRP. This might well be a way of applying indirect pressure on the PCT to undertake a proper retrospective review.

    I am not surprised that you have not got anywhere with the hospital complaints proceedure, their sole purpose IMHO is to block and convince people to give up rather than deal with the problem. You could go to the health ombudsman but I think you may be out of time on at least some of the care as complaints have to be referred to them within a year of the incident. Here is the link for you to raise the matter http://www.nhpct.nhs.uk/aboutus/pals/ombudsman.html

    If you want to proceed with a medical negligence case you would need to be prepared for a lengthy process of possibly several years and would need a no win no fee arrangement unless you have extreemly deep pockets.

    Incidentally one of your first points was made about rehab care. The probable reason this was not done is that under discharge processes rehab is at NHS expense.

    I hope this helps you see a way to progress.
  • i need to look at the files over the bank hols I think and make a decision as I am aware there is a deadline looming if I am going to fight on. I dont want to but feel it is so wrong that I must. She never had crutches and we got a wheelchair to get her out of the hospital, no one offered one and she wasnt offered any help anywhere, they just wanted her discharged and at home, it was us that said she couldnt possibly manage and they then said maybe a residential home would be best for a short period, but again, nothing arranged, we did all the work once they gave us names of where we could try, we had no idea where to start - she paid for everything, I so wish we had the knowledge at the time, but with an accident you just deal with what is in front of you, I had never heard of CHC - thank you for taking the time to comment, it means alot
  • Hi. Your experiences are horrendous but very familiar to me. I would urge you to just take it up today and press forward following Monkeyspanner's great advice. The PCT + SHA will have to listen and once you have begun you will no doubt have time to dot i's etc. just do it! The authorities do as MS has said, block you all the way.
    To my dying day I will have the words of the Community Matron ringing in my ears "the PCT say we must do this because you have not paid one penny towards your mother's care..." No, we didn't and I will be eternally glad that we didn't. Sometimes the admin mistakes they make can act in your favour, peversely. Such as the MDT meetings you refer to being mis-handled.
    I urge you to press on, today. The money is a matter of principle. And if you do win, go on a well earned holiday maybe. I would!
  • If you or a relative/friend were paying own care home fees and you believe the primary care needs were medical the government has imposed deadlines to make retrospective claim for repayment of care home fees under the NHS continuing care home funding scheme.

    If you paid for care between 1 April 2004 and 31 March 2011, the deadline to start the process is 30 September 2012. Starting simply means contacting your local Primary Care Trust and asking to be assessed. There's no deadline to complete the process by.

    If the care was received between 1 April 2011 and 31 March 2012, the deadline is 31 March 2013.


    MSE have just published a guide to making a reclaim including suggested letters to the PCT. http://www.moneysavingexpert.com/family/care-home-costs-reclaiming There is also a new comments thread.
  • Savvy_SueSavvy_Sue Forumite
    44.4K Posts
    Part of the Furniture 10,000 Posts Name Dropper
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    MSE have just published a guide to making a reclaim including suggested letters to the PCT. http://www.moneysavingexpert.com/family/care-home-costs-reclaiming There is also a new comments thread.
    That discussion thread is here.

    I'm going to close this thread, but make it a sticky so it's easy to find, and I'll ask the Forum Team to put a link to the article and discussion in monkeyspanner's very first post.

    Huge thanks to monkeyspanner and others who have shared their expertise in fighting these battles with us.
    Signature removed for peace of mind
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