Hi Rachel no i paid care home fees on my mothers behalf i had power of attorney we have paid £95000 in total including the sale of her flat. She tried to zip through every item with an airy wave of the hand, but as in the first assessment, we insisted on going through each item in detail, consulting medical records, etc etc to ensure that Dad’s true needs were being evaluated. It’s so so sad. Thanks, Hi Simon – anyone can request a checklist assessment to be carried out at any time. Your email address will not be published. Linear accelerator, which is a device used for external beam radiation treatments for patients with cancer. Christine Wilson. I asked around and was told he stood no chance, and because of all the intense stress I didn’t bother. Also, keep in mind that an MDT must comprise people who have direct knowledge of your husband and his needs. A further funding review then takes place in 3 months, and after that it should be reviewed annually. T Levels are new 2-year courses coming in September 2020, which will follow GCSEs and will be equivalent to 3 A Levels. Today I’ve had an email to say the DST has been scrapped as the checklist has been repeated and my mother found to have improved so she is not now needing any medical care. Catheters also have other uses, for example to widen obstructed blood vessels. I will keep you informed. You should be fully involved at every stage and invited to input, and there should be a multidisciplinary team including someone from the local authority. • Carry out a risk stratification for those appointments appropriate for This is the only way for it to be clear (clearly shown) whether or not a person remains an NHS responsibility. A test that checks for problems with the electrical activity of the heart. We found out when a social worker arrived to say ‘your father has no medical needs so is not eligible for nursing care’ We disputed that we had not been informed, allowed to attend, and had questions about the grades in the criteria checklist. A discipline in genetics that looks at the function and structure of genomes (the complete set of DNA within a single cell of an organism). My Mum had the checklist assessment on the 30th January but we have heard nothing since. If there's time to plan your caesarean, your doctor or midwife will talk to you about the potential risks and benefits of the procedure. She finally agreed the checklist would be redone. Not everyone is entitled to Continuing Healthcare (CHC). 6 | Clinical guide for the management of virtual working in secondary care during the coronavirus pandemic Virtual appointments: planning guide Decide plan • Establish a virtual clinic trust project team. Noises heard in the ear without an external cause, such as buzzing or ringing. And the scores should certainly not be changed without team discussion and without your involvement. Hi Peter. That’s how it’s done. Could you tell me how long it should be between the checklist being done and the full assessment? She has been in Carehome for 3 months and leading up to her assessment we noticed that her oxygen machine was taken away. (She then said dad was entitled to carers 4 times a day when you get him home but if it takes an hour to feed him they may not have time to do everything, or you could self-fund and I’ve brought a pack for you). After discharge home, she was poorly managed in the community and admitted to a rehab unit for some help with wound management which requires a special dressing and machine called VAC therapy. She also said that it was the responsibility of the people (Community Matron & OT) who drew up the DST to include any of `my` evidence. She then got awarded. Yet I have in my possession a Community Care Assessment that describes my late mother in law’s needs as “Critical” and two retrospective Claims Gate Keeping Checklists that have two A’s which I understand represents as someone with particular needs. My husband has PSP (Progressive Supranuclear Palsy), a degenerative, progressive brain disease that is incurable and terminal. Not everyone is on computers. It’s too late for me let it be a warning for others. It is a small flexible tube measuring about 40mm in length which is inserted under the skin. When I get my head a bit more straight I will do that and at least one more complaint may help someone else benefit. It talks about the full assessment being a checklist then, if passed, a DST and explicitly states ‘The first step in the assessment process for most … So a woman in her 80’s with very bad vascular dementia who has documented behavioural issues before entering the home, suddenly stops all the behavioural issues until a diary is kept and the behaviours suddenly start again? (a) there may be a need for such care, The LA & CCG seem to interpret ‘where it appears to that body that there may be a need for such care’ as the ‘clinical opinion of social & health professionals’. If the contractor is already confused, they are not competent to carry out the review. Techniques conducted in a laboratory setting, where a glass dish or test tube is used for observations made outside the body. She produced pages of a tick box score system which apparently goes to a local panel of ‘professionals’ for them to decide if they would provide funding. Continuing Healthcare (CHC) was awarded for part of the placement – potentially on decline in health status. Kind regards, Thanks, Angela. Is it better to do locally or apply to NHS England? My father is currently bed ridden, doubly incontinent, unable to feed himself and can hardly move. Very often the ‘evidence’ a CHC assessor will gather or acknowledge is either watered down or inappropriate. Outline why you disagree. I know which hospitals she was admitted to although the dates will be sketchy – do you think I will be able to get any information just based on her name and NHS number alone? My question is about the review answer above where you state:- I told her we were waiting for a new checklist to be carried out in line with national guidelines and she told me that last week the hospital and trust had changed the checklist procedure and my father had no nursing needs. The explanation will appear by hovering above terms in green. After she died there was a charge on property. Normally it’s a couple of weeks for them to let you know. Is it worth going to press with this or local mp or just give up. So your mum paid her care fees- that’s what you mean. I understand the local authority (e.g. You would have to complain to the local chc team. We are about to meet for the Independent Review Panel (IRP) but only if our evidence is presented to the Chair in advance. Different professionals meet together to discuss the diagnosis and treatment of patients. We have little or no records of who treated her save for a questionnaire that put her needs as “Critical”. The rapid access chest pain clinic is a nurse led clinic for the diagnosis of new onset angina. The guidelines are national and all CCGs must follow them – and abide by case law. Best wishes The main thing is don’t give up; that’s what they want. The Royal College of … Assessors seem to think they can be their own judge and jury and simply ignore their own guidelines. The three monthly review took place a few weeks back with a recommendation that we proceed onto the ‘usual’ CHC. 09939723. A system that incorporates processes to minimise all risks in an organisation. your primary care need is a health need. No one can say whether a person will be eligible for CHC until the assessment process has been carried out properly and until it is complete. Before we even had my husband’s health needs assessed, prior to the decision support tool meeting, a clerk in the CHC office told me we wouldn’t succeed, simply because the district nurse doesn’t routinely visit- she was right! General Osteopathic Council - the regulatory body for osteopaths in the UK. The checklist was completed and she had 2A and 4B. All content on the Care To Be Different website is copyright Continuing Care Solutions Ltd. What are the different stages of NHS Continuing Care assessment and ap... https://caretobedifferent.co.uk/wp-content/uploads/2013/03/Blank-elderly-lady.jpg, https://caretobedifferent.info/wp-content/uploads/2020/10/ctbd-logo.jpg. or hospital records to the Chair but have copied the Decision Support Tool, Multidisciplinary Team and local review reports and a few choice documents from the care home. She declined to answer the questions in the letter I had sent asking for clarification on which points we had fallen below the requirements and also said that it was a`closed` meeting so there were things she could not answer, i.e. I then got a copy of the DST and there were glaring omissions in the medical needs plus none of my comments were included, so I spent 4 and half hours going through the 38 page document and the guidelines, writing my comments and submitted them, also I complained that we had not been consulted in a meaningful way, as we had just been emailed the form with no clear idea what it was. A network covering a broad area, ie any telecommunications network that links regional, national or international boundaries using leased telecommunications. (The agency seem confused and the CCG nurse does not know who they are or what is happening. Our chief concern is how we are going to argue our case. Thanks for the very helpful post and the time it must have taken. The first step was not the checklist tool, the first step was passing an unknown health and/or social professionals ‘clinical opinion that it was appropriate to complete the checklist.’ So, for us, it wasn’t deemed appropriate (although no one told us) so no checklist instead jump to social needs assessment and means testing. We had an Independent Review Panel (IRP) – we were told a full panel was not required, they then told us my mum did not qualify. Some medical trainee pathway posts are such that, once the trainee starts a pathway, provided they meet the Annual Review of Competence Programme (ARCP), they will continue on that pathway until they reach the end of their training. Notify me of followup comments via email. We bought your guidebook and studied all your videos etc about NHS Continuing Care and after a very long assessment meeting, in which we kept going back to the lessons we learned from your stuff, we were granted funding for Dad. A serious inherited blood disorder where the red blood cells develop abnormally. Enables scientists to examine molecules and atoms at the smallest possible microscopic level. NICE . By relying on the subjective albeit professional opinion of those involved the various organisations decided that a checklist wasn’t necessary. Thanks for your very kind words, John. She has the same first name and I told them if it was the same nurse I spoke to yesterday I would refuse to have a meeting as she was part of the complaint I had just made to them! I believe the fact they ask the Social Services to attend and they refuse, mean that SS are accepting they were responsible for Mum’s care. It’s very upsetting and just stay strong. Thank you in anticipation. In a health setting this means having a concern for the whole person, where body and mind are linked. Yesterday a discharge nurse introduced herself by saying that dad had no nursing needs and wasn’t eligible for funding. I absolutely agree that not one penny should be spent taking disputes further by getting legal firms involved. At the end of the interview the assessor said she would email the RN at the nursing home when she had finished her report and If she disagreed with the outcome she could follow it up (not that I would have imagined she would) however no one at the nursing home had heard back before the paperwork was received by ourselves yesterday. 5) If you’re ineligible at the DST stage, you can submit a Continuing Healthcare appeal via the local NHS. ), Any information on this most greatfuly received. This article (above) takes you through the stages of the process. Anonamlous – yes, the Continuing Healthcare process generally starts with a Checklist assessment, whether that’s for you or for your father. So far the CCG have not provided the daily care records, G.P. The science of the functions of living organisms. Sets out the rights that patients, the public and staff are entitled to, and the pledges that the NHS is committed to achieving. You can ask a care home manager, social worker, GP or other health and social care professional to organise this – or you can contact the Continuing Healthcare team at the local NHS Clinical Commissioning Group (CCG). We have just had a meeting to go through the decision support tool “farce” and were turned down. A type of birth control. Apart from helping to answer the questions on the original and second applications, we had no input into this decision and we have never met our Social Worker. Hi Terrie- yes you can challenge the PHSO decision but this is the last stage without resorting to legal action. TIA, Kevin – Clinical Commissioning Groups (CCGs) remain responsible for Continuing Healthcare assessments and decisions. The examination takes place via a series of stations usually lasting 5-10 minutes, and the student progresses from station to station with a different examiner each time. She reiterated, when pressed, that she could not release any details of the meeting because it was not in the public domain, however she did say that `the panel felt for example that the section of the DST on skin condition had been `overstated“. The advocacy service in our area advised us to be aware that after the Local Dispute Resolution meeting if we are offered (and accept) another DST, and our mother is then found to be eligible she will get funding paid for from the date of that second DST date. The case has not gone to panel. I contributed verbally before she went on leave and was assured my comments would be included in the DST. Her original award was from Oct 2014 until her death in Jan 2016. Abbreviated to CCG. This means his care is by default an NHS responsibility and the NHS should pay (through CHC). I want to start the IRP ASAP so need to write to NHS England but do not know what I need to say. You can also subscribe to this post without commenting. Thanks. This was a lady in her 80’s who was totally immobile, doubly incontinent, had no conception of time of day, year, place or recognised any person around her or her family. I’m glad the website is helpful. So sad to hear your brother has passed away, Kate. This means that we have not been able to complete a Care Needs Portrayal and there is therefore no DST. The case coordinator or lead assessor cannot unilaterally change scores or notes on the Decision Support Tool (DST). After 2 years, his needs had become too much and too complex for us to manage and, during this time, apart from the GP who was very good with dad, the care services that were there for the first month, to help us settle dad back into home, just abandoned us. She has improved so that some days she is quite lucid and by sheer cussedness has improved walking to the extent that with the aid of a Zimmer frame and two people, managed to walk to the toilet. Outline which assessments have been carried out so far, and ask for a date for an Independent Review Panel hearing (IRP). In fact, if he had lived another three years he would have died a pauper. Does anyone know whether an appeal can be heard without the affected person being present. I’ve said it before – I’ll say it again – not everyone has a primary health need. When should NHS CHC checklist be completed? Regards And just because the NHS assessors may have failed to gather the appropriate evidence does not mean the need does not exist. Today on the advice of my GP, I contacted Pals who have arranged a meeting with a discharge nurse for me, mum an my husband tomorrow. A standard psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses. Yet I get a phone call today to say that ‘the panel had met and deliberated my fathers case, and had decided that he was not entitled to any funding because he does not meet the criterion’. I’m so sorry to hear about ur mum n the way in which her CHC was taken away. The local NHS appeal process resulted in another decision of ‘ineligible’, but they have made no mention of the independent review and only offered a meeting with a ‘senior manager’. Hi Sarah – Yes, there are several flaws there: 1) There should have been a local authority representative; this is absolutely vital: http://caretobedifferent.co.uk/nhs-continuing-healthcare-assessments-2/ 2) The meeting should not have started without you, regardless of what they told you beforehand 3) They should have carried out a Mental Capacity Assessment for your father before doing anything. Ok- but what I’m saying is that if it’s gone to review and there was no evidence there is unlikely to be evidence further down the line. The Certificate of Eligibility for Specialist Registration (CESR) provides an alternative route to the specialist register for those doctors who have not followed a traditional training programme, but who may have gained the same skills as CCT holders. Just over a year ago she was admitted to hospital and we were told she could not go back to the care home and was being placed in a 6 week assessment bed at a care/nursing home. • Agree what hardware and software will be used and ensure staff have received appropriate training. The review meeting happened without us knowing the following day as I complained to her doctor . This enables mechanical ventilation, for example during surgery or as an emergency procedure. The new Social Worker has written in the new My Care and Support Plan: Where a member of staff is available to be called for work, usually outside normal working hours. I have arranged for my mother to be reviewed by her surgeon again as I’ve said I want an up to date surgical opinion before agreeing to any discharge plan. 🙂, Hi. The fact that it has taken four years to respond to our claim yet they have given us 14 days in which to submit further evidence says it all. You were a little quick to judge me I think. Measurements are made in nanometers. Patients are usually referred by their GP; however referrals are also accepted from A&E.The aim is to facilitate expert opinion, early investigation and the risk stratification of chest pain. ‘clearly shown’? Since then her condition has fluctuated, 2 more strokes, one emergency admission to hospital, all the time her condition does deteriorate. Hi Kevin, The Full Assessment placed her in High or Medium for seven of the Domains. The vital thing at this point, though, is to make sure she is properly assessed for CHC before the 6-week funding runs out and, if it hasn’t been done properly within that time, to insist the funding continues until it is done properly. I have politely challenged the ombudsman’s decision but she wouldn’t change her decision. Many thanks Dear Angela,after mum’s CHC assessment we were told she needed 24hr nursing care,she scored 1 high and 5 moderates in the care domains so she did qualify for some NHS funding ie. Confirms that a doctor has completed an approved training programme in the UK and is eligible for entry onto the GP register or the specialist register. There’s something funny going on around stages 5 and 6 in the case of my appeal/s on behalf of my mother. Is that not the case? Being in a nursing home does not entitle someone to CHC. He has been told does not meet criteria for CHC as he is not ‘end of life’ my understanding is that if he has high primary health needs which are complex and intense etc then he should meet eligibility and that CHC is not just for end of life stage? The government will release a new date for back dates chc or you can dispute. Or would it be from the date of us being informed? They have not directly addressed any of the areas of dispute we have put forward or the errors made at the Local Resolution Meeting, where they referred to evidence which was outside and prior to the claim period and not relevant to the condition of my Mother at the time of the claim for NHS Continuing Healthcare (CHC). In the meeting she was graded as 1severe, 3high, 3moderate, 4low. Care To Be Different is a trading name of Continuing Care Solutions Ltd, Registered no. Abbreviated to AfC and also know as NHS Terms and Conditions of Service. A Checklist can be carried out by one person – but that person must understand the process and be familiar with your relative’s care needs. http://caretobedifferent.co.uk/nhs-continuing-care-review-process-new-timescales/, Thank you Angela. I think the decision was made before the meeting even began. Required fields are marked *. My experience is that you will face a panel of up to 6 professionals, including (but by no means exclusively) those involved in the patient’s care. Abbreviated to LAN. You then need to put together in writing all your reasons for disagreeing with the decision to deny Continuing Healthcare funding. If you’ve gone all the way to ombudsman then you have tried everything. Complain strongly about the flaws in the process and state that you will be appealing. Our family have been to hell and back for the last few years and suddenly she is alright. Treatment given in a large regional hospital that provides highly specialised care, for example in cardiac surgery or oncology. https://www.youtube.com/watch?v=yiN5cK50FS0. But you’ve gone higher. I know it’s cynical but it does go some way to confirm my own feelings about my Mum’s assessment. The Acute Team nurse didn’t answer my desperate calls for help just as we were on the verge of needing hospitalisation ourselves for sheer exhaustion, my dad’s condition just kept on getting worse and I wanted him assessed for CHC again. Basically it’s all down to money and (as you will be aware) Continuing Health Care is expensive! Gasp! You may also find this additional article helpful: http://caretobedifferent.co.uk/appealing-a-continuing-care-funding-decision/. We are considering a trip to NHS England to deliver the box but in the light of your experience wonder whether this is a waste of time and that we should consider legal action instead without a solicitor, having spent thousands already and yet we still know more than the solicitor about the process. And we haven’t even got as far as the checklist being done properly yet! The contractor should not do it in isolation. help. Thank you. 10) Failing that you may have to go on to judicial review/legal action. 4. the Hospital records provide insufficient clinical data ditto the above Check the care notes at the nursing home to make sure they are accurate and comprehensive, and raise any concerns about omissions, errors or misleading language in the notes: http://caretobedifferent.co.uk/check-the-language-used-in-continuing-care-assessments/ Even if your mum’s care needs have reduced, they may still be of such a level that she continues to qualify for CHC. We have had an annual review meeting 4 months ago with only the NHS reviewer and ourselves present. Doppler effect (or the Doppler shift) is the change in frequency or wavelength of a wave. A selection of Trust policies are available via the links below, to request in alternative formats please contact the Information Governance team via email [email protected] or Telephone No. Do you have any publications to help with appealing at IRP? then said we would have to have a financial assessment. She is obviously still terminal though, Could they take it away from her ? Even if they get a private contractor to undertake the review, the CCG is still responsible for the way it is conducted and it is the CCG that must make the actual funding decision. She then said she would get a nurse to do the checklist immediately as ‘it’s just done by a nurse’. In addition, a genuine specialist solicitor or adviser, with solid coal-face experience in this field, can be invaluable. You’re quite right; CHC is not just for end of life – it’s for any stage of life. Take care and good luck. Hi Angela, NHS Higher Specialist Scientific Training. Can I just check – does my mum have some rights to remain there until the process is completed? While in there he was also diagnosed with CBD (cortico-basal degeneration: a rare degenerative, terminal brain disorder), with Parkinsonism, and dementia. The second assessment was done in June by our OT and the District Matron who took it upon themselves to push forward the second stage (with input from us too), as they could see that matters had become considerably worse. You can also approach NHS England directly and ask for an Independent Review. A medical procedure that is used to remove (ablate) or destroy the endometrial lining of a uterus. Without wishing to seem cynical, I cannot believe there are no records for a lady that was very ill for some years before she went into care and was still ill whilst she was there until her death. Funding will be awarded to you by the NHS to cover your care costs, including your social care costs, such as accommodation in a care home. As my mother-in-law has passed away and all bills have long since been paid by us there is frankly no chance of the money ever being repaid. My Mother was fast tracked to Care home as she was given End of Life plan because of COPD and not to be have any more recussitation or Bi Pap again. They are used to help pain outside the foot such as in the ankle, knee, hip or back. Also known as a “mini-stroke”, this occurs when there is a brief interruption of the blood supply to the brain, causing symptoms similar to those of a stroke. A register providing public assurance for the provision of a competent workforce that contributes to a high quality public health service. Point this out to the people obstructing you, and also ask them to show you in black and white where exactly it is written that CHC covers only end of life. The Community Mental Health Team / County Council are trying to get me sign agreement that is asking me to agree to be financially assessed for direct payments, in a Letter of Agreement, to see whether I need to make a contribution and for me try to enter into a contract. Suddenly she can feed herself, walk with aid to the toilet and suddenly a miracle has happened. Hello Peter, my partner of fifty years had a massive stroke in 2015. Also, if your relative is in ‘terminal decline’ or in a period of rapid deterioration, you can ask for a Fast Track assessment. A talking therapy that can help you manage your problems by changing the way you think and behave. i was told at CCG meeting i was entitled to panel however the ombudsman agrees with NHS. He was deemed eligible for full CHC assessment upon discharge into intermediate care for a month while we prepared our home to look after him full time for as long as we could. Surgery for weight loss, such as gastric bypass surgery or gastric band. They claim that: The person who started the process went on leave. 9) If you’re found ineligible for funding at the Independent Review, you can approach the Health Ombudsman. A solicitor’s letter may help at this point. It’s a question of building a strong case, domain by domain, highlighting why the needs represent a primary health need and challenge every single thing that has been done incorrectly. The first year of training is known as FY1 and the second FY2. All domains were wrong and differed from GP’s notes, however the ombudsman thought it ok to be refused Independent Review Panel (IRP). She mobilises well and doesn’t have any more rehab needs per say, which is probably what annoys them. The previous Social Worker assessed me as: Overall Fair Access To Care Services (FACS) Eligibility: Critical. A problem with the body’s immune system, when it starts to attack healthy cells, tissues and organs. I don’t have the money for a solicitor, but that will not deter me. Thanks for your comment Chris. A computer network that connects computers within a limited areas such as a home, hospital or office buidling using network media. Symptoms that indicate a potentially serious disease and warrant prompt investigation and treatment. I do not want the family home sold or him to go into a Nursing Home. A long flexible tube is inserted, which has a camera and light at one end (known as an endoscope). My father is 71 and suffers from Depression, is my Carer and Appointee. We completed the full assessment paperwork today. Subsequently I have had a phone call from the social worker (still haven`t met her) who asked lots of questions (my carer`s assessment perhaps ?) Uses X-rays and a computer to create detailed images of the inside of the body. Angela – I’m glad the book was helpful; that’s always good to know. Within a week of being denied NHS continuing healthcare because she was assessed as being too highly so did not warrant funding my Mother died! Very clever of them as none of them have met my husband, so how can they conclude that ? £109/week,I am thinking about appealing because it was stated that mum’s medical problems were easily managed,, she has been in the nursing home for a month and was readmitted to hospital today because her oxygen levels are worryingly low and she is very drowsy it is difficult to treat because she retains carbon dioxide.I would be interested in your thoughts please. Training for registered clinical scientists to enable them to practise at consultant healthcare scientist level. And these people are nurses who are saying this? An initial Checklist was completed which my sister passed. 2100 characters max. Can I apply for CHC for him post-death as I feel that the NHS Continuing Healthcare system badly failed my dad and also us? Plus at IRP a social worker from another county comes in to put across the social services view. I cannot afford legal advice at all. We’ve outlined here the various stages of NHS Continuing Healthcare assessment and appeal – and who you need to contact in each case….

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