How Long Does it Take to Recover Care Home Fees from NHS?

Author:
James Urquhart-Burton
Partner, Care Home Fees Solicitor
Date:
04/09/2019

In most cases, depending on how long the NHS takes to process a Continuing Healthcare Funding claim, we would expect a claim to take between 18 and 36 months to conclude under normal circumstances.

It’s been well publicised that there can be lengthy and unreasonable delays in claiming care fees back, but at Simpson Millar, we’ve recovered over £12 million in care fees for our clients. With the help of our Care Home Fees experts, we can take out the unnecessary strain from this complex procedure.

For a free, no-obligation discussion on the recovery of fees already paid, get in touch with our Care Home Fees Solicitors – ask if we can deal with your claim on a No Win, No Fee basis.

Call us on 08002605010 or request a callback and we will help you.

NHS Continuing Healthcare Funding is also known as CHC Funding.

Potential Delays in Claiming Back Care Fees

The extent of the delays could be down to a number of factors, including:

  • When your claim was made - If a number of claims were made prior to yours, these will likely be dealt with first
  • Whether the patient is alive or deceased - The NHS will make much quicker provision for funding for those who are alive and are in need of care, than for those who have already passed away
  • Whether you have the correct legal authority to make a claim on behalf of the patient if the claim is not for you but for a loved one. You may need to apply for a Grant of Probate to administer any care fees recovered and this can take time
  • Issues securing evidence, such as securing copies of care home records from the care home
  • Whether the Clinical Commissioning Group (CCG) dealing with your case is having staffing and resourcing issues
  • Whether you decide to exercise your right of appeal if turned down for funding, which will add considerable time to the total duration of the case

Submission Deadline to Claim Back Care Fees

In 2012, the Department of Health announced deadlines by which to submit a claim for anyone who had not been assessed for NHS Continuing Healthcare Funding between 1 April 2004 and 31 March 2012. The NHS was overwhelmed by the number of claims submitted, which are believed to have been in excess of 60,000.

As a result of resourcing constraints and inefficiencies, the NHS is still processing a number of these claims some 7 years on.

As time goes on it is anticipated that the NHS will be able to handle these claims more quickly, but this will depend on whether the Department of Health announces further deadlines in relation to claims from 1 April 2012 onwards.

In the absence of any further deadlines, we would expect a retrospective claim to take between 18 and 36 months to conclude under normal circumstances.

Assessed but Not Eligible for Funding?

If your relative was assessed as not eligible for CHC Funding and you disagree with that decision, it is very important that you appeal against the decision promptly. The time limit for lodging an appeal is usually 6 months.

If your relative was assessed as not eligible for funding but you did not appeal that decision in time, you may not be able to make an appeal or bring a retrospective (backdated) claim, however, it may still be possible to bring a claim and Care Home Fees Solicitors will be more than happy to investigate this further on your behalf. We, therefore, recommend that you seek specialist legal advice in these circumstances, as there might still be grounds for you to make a backdated NHS Continuing Healthcare Funding claim.

We can help you show that your relative’s health and nursing care needs were greater than what could be provided for them by Social Services, which may entitle them to funding from the NHS.

For a discussion with no obligation call our Care Home Solicitors

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