Lawyer Supported CHC Funding Meetings Case Study

Author:
Hannah Morris
Care Home Fees Lawyer
Date:
11/09/2019

Client Situation

Mrs B contacted our Care Home Fees Lawyers to get legal advice about a case involving her sister, Mrs C, for whom she has Power of Attorney. Mrs C had previously been receiving NHS Continuing Healthcare Funding (CHC Funding), but this had been withdrawn.

Mrs C is in her 60s and receiving care in her own home. She suffers from multiple health conditions including unstable epilepsy and cognitive impairment. Because of her health conditions, she needs 24-hour care.

Withdrawal of Mrs C’s Continuing Healthcare Funding meant that she was paying for her own care and Mrs B, as her Attorney, would have to go through the process of applying for NHS Continuing Healthcare Funding all over again.  

Mrs C’s health deteriorated further, so a new assessment date was arranged by the Clinical Commissioning Group. Mrs B was very concerned that Continuing Healthcare Funding would be refused again so she contacted our Care Home Fees Lawyers for advice and assistance.

How We Helped

Care Home Fees Lawyer, Hannah Morris attended the Multidisciplinary Team meeting with Mrs B and Mrs C. As Hannah was instructed to attend this meeting, she offered help and advice and made sure the best case was presented on the day. She was aware of the full situation and had helped to secure the initial recommendation put forward to the Clinical Commissioning Group.

Despite a recommendation at the end of the meeting by the Multidisciplinary Team that funding should be awarded, the Clinical Commissioning Group refused to ratify the decision. They insisted there was insufficient evidence. Another Multidisciplinary Team meeting was proposed to resolve the matter.

Mrs B was very reluctant to go back to the Multidisciplinary Team and answer the same questions she had already answered. She felt that this was just an attempt by the Clinical Commissioning Group to refuse to fund. But she realised that she needed to continue trying to secure funding for her sister’s care.

Mrs B asked Hannah to attend the second CHC Funding meeting. She focused Mrs B’s comments on the eligibility criteria against Mrs C’s health needs, rather than the concerns about the process.   

Hannah gave Mrs B help, advice and guidance on the day, along with her full support. By assisting the Multidisciplinary Team in answering the Clinical Commissioning Group’s questions and evidencing Mrs C’s presenting care needs, the initial recommendation was supported and the recommendation again went back to the Clinical Commissioning Group for full NHS Continuing Healthcare Funding to be awarded.

The Outcome

The final decision from the Clinical Commissioning Group was to award Mrs C full Continuing Healthcare Funding again.

Mrs B was hugely grateful for Hannah’s support throughout the process. She felt that the NHS had been trying to avoid their responsibilities, and Hannah’s guidance and presence at the meetings had proven invaluable in helping her secure full funding for her sisters care.  

For more information see How to Appeal an NHS Continuing Healthcare Funding Decision.