On enquiring three months’ later when the full assessment would be done, I was told by the District Nurse that they were not happy with the initial assessment, they thought it was too generous to my sister and that they were going to repeat it (until they got the answer they wanted, presumably). A problem with the body’s immune system, when it starts to attack healthy cells, tissues and organs. Julie. 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. The NHS must adhere to Dept of Healthâs Continuing Healthcare review timescales in dealing with your request. My father is 71 and suffers from Depression, is my Carer and Appointee. Many thanks for coming back to me and for your help. Stressing that x will (at the time) be subject to a re-assessment of her needs under legislative framework of the Care Act 2014.”. Caused when there is interruption of the blood supply to the brain, which is often the result of a blood clot in a cerebral (brain) artery (ischaemic stroke). The Multidisciplinary Team (MDT) make a recommendation for a panel to ratify. They won’t be able to. 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. The administration of drugs or other fluids into the body by any route except via the gastrointestinal tract (for example by intravenous or intramuscular injection or infusion). Thanks for the very helpful post and the time it must have taken. The Health and Care Professions Council. Ingrid – funding should be backdated to shortly after the original Checklist. At stage 1 discuss your issues. The assessors are acting incorrectly in not arranging the date and time of the MDT to accommodate you. Care of the wound site. This means his care is by default an NHS responsibility and the NHS should pay (through CHC). A flexible tube that is inserted into the body to remove or introduce fluids. When I get my head a bit more straight I will do that and at least one more complaint may help someone else benefit. Naturally we took over matters by which time m-I-l was in the care home. A type of examination used in medicine and other health professions to test a broad range of clinical skills and other skills such as communication. It strikes me that the local IRP is just down the road from our local NHS (who gave us the address in our ineligibility letter) .. and we worry about the supposed independence. Melanie – that sounds like a very distressing situation for you all. I should point out there is no change in my mother’s condition. 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. I could drive a truck through the holes in their decision, so it’s not like the meeting could possibly achieve anything. I appreciate your Mental Health records – ditto the above 5) If youâre ineligible at the DST stage, you can submit a Continuing Healthcare appeal via the local NHS. A social worker or other local authority representative must be involved. My question really is, is it worth the hassle appealing? In all that time, despite requesting that he should be assessed again, he never was. The administration of different drugs taken together, which increases the likelihood of side effects from drug interactions. By clicking Subscribe you also confirm you have read and accepted our Privacy Notice. (2) A relevant body must take reasonable steps to ensure that an assessment of eligibility for NHS Continuing Healthcare is carried out in respect of a person for which that body has responsibility in all cases where it appears to that body thatâ 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). Thank you Angela. 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. They did say it would be a while but it is 2 months now. I can’t do anymore as I cant afford to go to court. Competition ratios tell you how many applications were received relative to the number of places available. 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? It temporarily numbs your nerves. Normally it’s a couple of weeks for them to let you know. This will then be used subsequently for the basis of an assessment for Continuing Health Care. Note: of you don’t go through the motions of any Local Dispute Resolution process first, you may find that NHS England will send your case back to the local CCG for this to be completed before you can receive a date for an Independent Review. • Agree what hardware and software will be used and ensure staff have received appropriate training. The explanation will appear by hovering above terms in green. Abbreviated to PDP. Thank you. The case coordinator or lead assessor cannot unilaterally change scores or notes on the Decision Support Tool (DST). She has Myeloma which they have stopped treatment for and was diagnosed with severe vascular dementia. Very clever of them as none of them have met my husband, so how can they conclude that ? An action plan based on self awareness, values, reflection, goal-setting and planning for career development. We have developed this glossary to explain these terms in more detail. My brother recently passed away while in a care home, he had been reassessed for his CHC about four weeks before his death and the NHS have paid for his care in full for the last ten days of his life, however he was moved from his previous care home at that time as they were finding it difficult to care for him. A raised, itchy rash on the skin. She was then transferred to a lovely nursing home. 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. Is this normal and who do I chase it up with it not? I absolutely agree that not one penny should be spent taking disputes further by getting legal firms involved. My question is about the review answer above where you state:- Thank you for your kind words, David, and I’m so glad you managed to secure CHC for your father. Is this normal that gradings can be changed after the assessment? In desperation, I emailed our MP who acted swiftly, got an apology for neglecting dad from the county head of care services for us and a promise to look into his needs again as quickly as they could. Outline which assessments have been carried out so far, and ask for a date for an Independent Review Panel hearing (IRP). It sounds as though your mum has been given 6 weeks intermediate care funding. Linear accelerator, which is a device used for external beam radiation treatments for patients with cancer. ‘clearly shown’? Whether our Mum scores A or B or High or Moderate she still needs every day to be hoisted and delicately fed and given Physio and skin treatment. If this is the correct interpretation of the regulation then I can’t square this off against the definition/ establishment of a primary health need (PHN). Including money from the sale of her flat- your mums money. If your relative needs to be assessed for NHS Continuing Healthcare funding, you may be wondering what the different stages of NHS Continuing Healthcare assessment and appeal are. You were a little quick to judge me I think. Another social worker has contacted me to say that meeting is now scrapped and I have to a attend a discharge planning meeting. We have gone through the Checklist and Mum qualified for Full Assessment after being placed in the A or B sections for most of the 11 areas. Actors may be used in place of real patients. 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. Not everyone in care is there because their needs are above and beyond what social services can provide. This article (above) takes you through the stages of the process. The science of the functions of living organisms. It is usually viral. A lot of stuff we discussed was cherry picked and stuff that we presented and discussed which was in Mum’s favour has been omitted from the “snapshot minutes” as the lady just told me they were. Thanks I have seen this, its actually one of the things that caused me to raise my question. That’s how it’s done. Abbreviated to UKPHR. What I mean is that the review must be done properly and all domains fully explored and all care needs properly assessed – and by the right people. Some of the links in the following article may help you further: http://caretobedifferent.co.uk/nhs-continuing-healthcare-funding-28-useful-links/, Hi, 6 weeks go my 90 year-old father had a massive stroke and cerebral oedema and despite be told he would not survive, he can talk (not always lucidly), swallow (sometimes forgets what he’s supposed to do),needs to be given food and fluids but is immobile(has bedsores), doubly incontinent, has polymyalgia rheumatic, is on long term steroids, anticoagulants etc. Good luck! It is a worry and I got upset at the meeting as I felt they had it all panned out. Our chief concern is how we are going to argue our case. Around 90% of patient interaction is with primary care services. 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. I have now been told that we cannot appeal because and I quote – “As we were unable to complete the first stage of review, we were then unable to complete any further documentation. A medical procedure that is used to remove (ablate) or destroy the endometrial lining of a uterus. So far the CCG have not provided the daily care records, G.P. As you can see from blogs and forums across the web, care homes are often notoriously bad at keeping notes for CHC assessments. 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. Noises heard in the ear without an external cause, such as buzzing or ringing. I WILL go to Independent Review. 09939723. As a background to this, when I managed to speak to the county CHC team about three weeks ago requesting another ‘quick’ full assessment as he was clearly going downhill fast, they came back with the end of April, which I argued against as I felt sue he wouldn’t still be with us then, and they came back with the end of March for reassessment…again, too late for him to be alive for, I thought. Do not take painkillers that contain aspirin. It is ridiculous. It sounds as though you’re very determined, which is exactly what’s needed. The meeting was a charade, a waste of everyones time and I wonder how so called ‘professionals’ can bring themselves to participate in such a dishonest sham. 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. A blood clot in the pulmonary artery or in the lung. In Telford and Wrekin you will be invited to attend a vaccination appointment at a local GP service, a local hospital service, a local pharmacy or at a large vaccination centre. They have failed to report many things and take into account evidence they have been given. If the contractor is already confused, they are not competent to carry out the review. I am very active on a degenerative illness forum and regularly point people here and then if need be I support them to follow through on your advice. Relating to the whole thing rather than just a part. S117 applies to her because she has been under S3 of the Mental Health Act and still requires Related Care. Plural of tracheostomy, an opening created at the front of the neck so a tube can be inserted into the windpipe (trachea) to help you breathe. Telephone each of the teams and ask if they do have records and for the names of the Consultants heading up the teams. I am concerned the fact the Social Services budget, unlike the NHS Continuing Health Care has been cut and Social Services will only fund my Care if I am forced to instead to live in Mental Home with men as opposed to the family home, should my father’s health fail or if he died. 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. Hi Terrie- yes you can challenge the PHSO decision but this is the last stage without resorting to legal action. Deoxyribonucleic acid. 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. 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! At this point a form called the âDecision Support Toolâ (DST) is completed by a Multidisciplinary Team (MDT) – not just by one person. 2) If you don’t get through the Checklist, and you disagree with that decision, you can request another Checklist assessment. If you would like guidance or advice on this please contact us and we will talk you through the process. Since then her condition has fluctuated, 2 more strokes, one emergency admission to hospital, all the time her condition does deteriorate. The actual decision is made afterwards. The first point of entry into hospital for patients who have been referred as emergencies by their GP or who require admission from the A&E department. If these things haven’t happened, make a complaint to the NHS Continuing Healthcare team and also the Head of Adult Care at the local authority. A common condition in babies and young children resulting in narrowing and inflammation of the airways that causes hoarseness, noisy breathing and a cough. She was talking about the quantity and quality of the evidence. Joy – if the nurse and the social worker did a genuine Continuing Healthcare assessment, there should be formal paperwork to accompany this. It sounds as though the assessment team have wrongly excluded you from the process, Barbara. Hi Kevin Regards nigel. 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. 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. 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. Write to the local NHS Continuing Healthcare Dept and say that you disagree with the outcome of the MDT assessment and you would like to appeal formally. This is borne out by the thousands of comments from families on this website. The NHS reviewer was quite tetchy as she obviously didn’t want to go through this. She is in a nursing home and was fast tracked for continuing funding in February 2014 when the hospital advised she was dying. Involves the administration of live-saving chest compressions to someone who is not breathing or who has suffered a cardiac arrest (heart attack). help. Hi without sounding too flippant you need to find a different care home. This is a alternative to general anaesthesia when the surgical site is located on the lower extremities, perineum (eg, surgery on the genitalia or anus), or lower abdominal area. The insertion of a hollow needle into the spinal canal, to inject drugs or other substances or to withdraw cerebrospinal fluid. The ombudsman is investigating our case and hopefully if found in our favour oe disregard of doctors notes, wrong procedure, we hope to claim all fees ie £95000. https://www.youtube.com/watch?v=yiN5cK50FS0. Most alarmingly, if the CCG nurse has no clue what it happening, the whole thing is likely to be a shambles. In the meeting she was graded as 1severe, 3high, 3moderate, 4low. Agenda for Change. Is it better to do locally or apply to NHS England? How they can do that seems utterly stupid as they have no personal knowledge of the client. Many people find this book a cost-effective starting point, It takes you step-by-step through the whole NHS Continuing Healthcare process, right from the start, including how to approach the NHS, what should (and shouldnât) happen, the pitfalls to avoid, what to do and say before, during and after an assessment, whatâs right and whatâs not, how to challenge decisions, how to pull apart the NHSâs assessment notes, etc. I’ve said it before – I’ll say it again – not everyone has a primary health need. 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“. I purchased your guide on how to avoid care fees, hoping it would help our quest to receive Continuing Healthcare for my husband, whose health was damaged by the NHS, by giving him radiotherapy to his brain (prophylactic- he never had a brain tumour)-causing him to be unable to walk, doubly incontinent, verbally aggressive, permanently on steroids, warfarin, and with severe cognitive impairment. I found a very good nursing home. The abbreviation for attention deficit hyperactivity disorder. What should my next step be ? A test that checks for problems with the electrical activity of the heart. My family and I are in exactly the same position as you as my mum was rushed to 24 hour nursing care following numerous stays in hospital for chronic palliative COPD. Check out page 25 paragraph 74 of the National Framework: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213137/National-Framework-for-NHS-CHC-NHS-FNC-Nov-2012.pdf. Our claim is not massive, it is the principle that counts. A system that incorporates processes to minimise all risks in an organisation. Examination of a body cavity using an endoscope, which is a flexible or rigid tube with a small camera and light. My Mum is double incontinent cannot feed herself she does not know who we are now and is failing in health. She was not eligible for funding. Thanks for your very kind words, John. You can also subscribe to this post without commenting. I have just heard that my late mums Continuing Healthcare (CHC) local resolution meeting has resulted in the CCG still not awarding her CHC for the first year and 3/4 of being in the nursing home. District Nurse/Community records – ditto the above Click one of the letters above to take you to the terms beginning with that letter. I asked around and was told he stood no chance, and because of all the intense stress I didn’t bother. There is much that we disagree with in the conclusions the MDT have made and contraventions to the Framework but should we appeal at this stage as we are being told to or wait until we hear from the CCG? We have had an annual review meeting 4 months ago with only the NHS reviewer and ourselves present. A lifelong condition that significantly affects how someone understands what is said to them and /or how they express themselves. Nigel – just in case it adds any weight to your appeal to the Ombudsman, this is what the NHS itself says should happen at an IRP. Fissure sealants are plastic coatings that are painted on to the grooves of the back teeth. Thanks for your comment Chris. 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? I have no idea what `evidence` they have looked at, or if any other things were considered. 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. The three monthly review took place a few weeks back with a recommendation that we proceed onto the ‘usual’ CHC. Fran – what utter nonsense from the CCG. We are about to meet for the Independent Review Panel (IRP) but only if our evidence is presented to the Chair in advance. Social services can place in nursing homes. ), Any information on this most greatfuly received. I have now written to the CCG and told them that we wish to appeal – I don’t see that they can make a decision based on no information and feel that they have just done this to put another case in the “done” pile. You could write to the Head of Adult Care at the local authority and state very firmly that the local authority may be in an illegal position by not being in involved in looking at the legal limit for their care: http://caretobedifferent.co.uk/nhs-continuing-healthcare-should-social-workers-be-involved/ In addition, use the Care Act to highlight the NHS’s failings to the discharge team and/or the assessors: http://caretobedifferent.co.uk/care-act-2014-helps-you-with-nhs-continuing-healthcare/ Keep going if you can. who was present at the meeting, a copy of the minutes and what `evidence` they looked at. I do not want them to say we are not able to look after each other. The whole thing is a scam . The health sector can sometimes use jargon. She then got awarded. Hear what our staff have to say about their NHS careers, Download resources to help you with your career decisions, Access a range of support and resources for the classroom. Surgery for weight loss, such as gastric bypass surgery or gastric band. They claim that: Please advise if it’s worth appealing against the decision-is it ever overturned? Not sure what our next move is. This was ignored. NHS Scientist Training Programme. Advice would be much appreciated before we implode! ð, Hi. Let’s hope we win. We have no support from the family, they neglect us. This is made clear in the National Framework guidelines. Examination of the airways using a bronchoscope (a flexible or rigid tube with a small camera and light at the end). If you are going to dispute- sound like process was not followed. Please can you tell me how long I should expect to wait for a response and should I now take the matter to the ombudsman? You should have had a financial assessment for your mum from social services. 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. The bedsore was looking miraculously better. She had serious dementia. Also I’d like to know if my husband’s health records should have been taken into account? Secondary care services are usually provided in a hospital or clinic. The hereditary material in humans and almost all other organisms. Sorry if this is confusing, it certainly confuses me!. The main thing is don’t give up; that’s what they want. Anonamlous – yes, the Continuing Healthcare process generally starts with a Checklist assessment, whether that’s for you or for your father. Yes, let them know you would like your case to go to an Independent Review (IRP). I have now been advised that a MDT will be held on 17 June 2015 as the NHS feel her condition has improved and that she should no longer be funded. Whether the area you are in will depend if it’s on time. This may help you in advance of the proper Checklist:http://caretobedifferent.co.uk/how-do-you-know-if-a-continuing-healthcare-assessment-should-be-done/. 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. To have a primary health need the mdt look at nature, intensity, complexity and unpredictability. 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. I look after my husband at home, with help from carers who come in to wash him, get him up, then back to bed at night. She was being hoisted and was very confused. What guidelines should be followed in Continuing Healthcare assessments? 2100 characters max. He scored Severe on several points and I have been expecting to be called for a meeting of the local panel, however I have received today a letter stating that ” the Continuing Healthcare Panel looked at all of the evidence available. At my relative’s recent MDT meeting, neither the NHS Assessor nor the Social Care Assessor would offer their scores for the domains only my sister, myself & the nursing home’s nurse were asked to offer scores. ð. My question is are they correct? I have been busy contacting all professionals involved with my husband`s care, GP, Consultant, Parkinson`s nurse, daycare manager,homecare provider etc to request supporting letters for the appeal. Thanks for your comment, Cathy. The team consists of community nurses, community matrons, physiotherapists, occupational therapists, specialist palliative care nurses, mental health nurses and health care and rehabilitation assistants. I agree that it sounds highly questionable, and it’s hard to see how the motivation behind the phrase ‘manage the eligibility criteria’ could be anything other than unfairly stopping people receiving the funding. I don’t know whether to appeal or not, if we still had the severe grading would the outcome been likely to be different? In your Care fees document (which we have found such a terrific help and Guidance) there is regular focus on this term “primarily healthcare” and we just cannot understand why this has to be so minutely studied. It is an absolute joke!!!! (The agency seem confused and the CCG nurse does not know who they are or what is happening. It has been established that `P` does not have a primary healthcare need of a nature … to meet the eligibility for NHS Continuing Healthcare Funding”. It describes the stages of the wound healing process and explains how they relate to nursing practice. Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs. Where a member of staff is available to be called for work, usually outside normal working hours. 01752 431547. Outline why you disagree. 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.
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