Well we are up for our annual CHC re-assessment today. So I have been reading up a little.
I am gradually working my way through intricacies of Continuing Health Care.
I am drawing heavily on Angela Sherman’s work from her website and her book.
She points out that she refers to the elderly throughout her work, but that the information is completely valid for any age group.
Angela had a fight to get Continuing Health Care for one of her parents and now she has this superb website and works as an advocate helping people win their cases.
caretobedifferent.co.uk/abo...
She has published a superb briefing paper available for free here.
caretobedifferent.co.uk/abo...
Just scroll down to "download our free 17 page eGuide. "
It is simple and clearly written. It really is worth a read.
Here are a few key bits of information from the eGuide:
Social Care provided by the Social Services is means tested.
Continuing Health Care provided by the NHS is not means tested and it is completely free at the point of delivery.
She points to the incorrect, and sadly common, comment from the NHS saying that washing and bathing are Social Care Needs and that you need to go to the Social Services and thus the means tested system.
The condition for Continuing Health Care is that the applicant needs care primarily for health reasons. Not that all needs are nursing needs.
Questions about finances should never be asked in a CHC assessment. It's not means tested and so that is non of their business.
If you qualify for CHC you qualify for all of the needs to be met. If they try to part fund and refer you for Social Care (means tested) they are not following the law.
You have a right to an assessment for CHC (get your GP to refer you). If they do a brief visit and say you don’t qualify and there's no point doing an assessment, stick to your guns and say you want an assessment because without it neither you nor them would really know.
Social Care:
There is a good para about social care and reasons why your home should not always be included in the means test. One is your partner lives there and another relative over Sixty lives there. There are other reasons too.
Staying with Social Care only the person requiring Social Care should have their assets assessed not the spouse’s assets or joint assets.
Back to CHC:
“If your relative needs full time care AND they have any degree of
health needs or nursing care needs, then they should be assessed for
NHS Continuing Healthcare funding.”
“The assessment process
There are two main stages to the assessment process. The first stage is called a ‘Checklist assessment’. This initial Checklist does not determine eligibility, but instead determines whether a person should go through to stage two, the full assessment.
At the Checklist stage many people are simply told they ‘don’t qualify’, and yet their needs may well have been assessed without due regard to the National Framework guidelines and the Checklist assessment criteria. This also happens at stage two. You can appeal. (Stage two is sometimes known as ‘the DST’, which stands for Decision Support Tool; this is the name of the form used during stage two.)”
Read more about the various stages of the assessment process here.
If you qualify for CHC you qualify for everything. All needs should be met through CHC.
Angela has noted that she is seeing more cases of funding being withdrawn. She believes this is often based on Trusts wanting to protect limited funds and poor assessments. Read that section if that is you. There is an appeal process.
Finally there is a section on Funded Nursing Care (FNC):
This is only for those who do not qualify for CHC.
Essentially it is a new and rather worrying development where the person pays for some of their Nursing Care.
You should always be assessed for CHC before FNC is considered.
Well I guess that has got me in the mood to face the assessing Nurse!
I hope this is useful as an opener on the subject for those who don't know.
I will post more when I have finally digested the manual. Lactulose is standing by.
Good luck to all.
Kevin
