Continuing Health Care Reviews.

[Kevin_1]

I read of cases where people qualify for CHC and some time later they have the funding withdrawn at a review. The scenario I see the most is that the CCG say that because they are bed bound and unable to move very much, their risks have diminished and they no longer meet the 'score' they need in order to qualify for CHC.

So I thought to post some information about the review process.

From Age Concerns Fact Sheet 20

ageuk.org.uk/globalassets/a...

"Regular reviews of eligibility decisions

Regular reviews are part of the NHS CHC process and you have the right to be represented by a person of your choice. If you are eligible, or were considered, for NHS CHC and the NHS subsequently provides or funds any part of your care package, your case review should take place no later than three months after the initial eligibility decision and then at least annually. The MDT making the original recommendation may have specified different timing for your first review. The focus should be on whether your needs have changed and consequently whether your care plan needs revising,not on whether you remain eligible for NHS CHC.

[If] The CCG and LA should support a decision to remove eligibility and it must involve completion of the DST. If they disagree about your eligibility, they should resolve it using the local disputes procedure. During that time, the CCG must continue to fully fund your care. If the CCG and LA agree you are no longer eligible, the CCG should inform you in writing, with their reasoning, and explain your right to request a review of their decision. One month’s notice of a change of funding responsibility is reasonable."

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So it is entirely reasonable that one representative of the CCG undertake the review. However should they decide that the person is likely to be no longer eligible for funding a DST must take place. It would very bad practice for them to attempt to do a DST as part of the review as the review is supposed to be a health needs review. Not a funding review.

The DST necessarily requires Social Services to be involved and it is required to be multidisciplinary with a new cycle of evidence gathering.

[Satt2015]

Brilliant post Kevin! Thank you! 💕

As I said to you earlier your my knight in shining armour but actually not just mine soley, many people here think the same!

So on to some questions:

What is the LA? Local authorities?

If someone is bedbound and then fasttracked for chc in hospital and then their 3 monthly review is done at home and the chc is agreed for another year, can you please explain why at the next review when obviously the person is still and will continue to be bedbound could the funding from chc be removed? My point being that my Dad was bedbound at the last review so I personally don’t see how this score can differ on this review?!

Thanks in advance

And big hugs to you and Liz x

[Kevin_1 in reply to Satt2015]

Your very sweet... Hugs

Sorry - LA are Local Authorities. Busted for jargon - again 😿

Well, like many of us you are flying on the outside of the CHC air plane!

Fast track is predominantly for end of life care. The last ?is it twelve weeks? - I could look it up if you wanted.

However it is sometimes used as a short cut when CHC is clearly needed. It's not supposed to be and it's use for that seems much rarer now.

It shouldn't affect anything. They can't (or shouldn't) remove fast track without doing a DST.

And that is not just a quick filling of the form. It has to be a full evidence gathering followed by a proper multi disciplinary DST.

xxx

[Satt2015 in reply to Kevin_1]

Got ya! Thank you Kevin!

Finally for this review there won’t be a DST or at least shouldn’t be?

💕 x

[Kevin_1 in reply to Satt2015]

Yes, reviews are supposed to concentrate on needs and they are not about funding decisions.

So if the nurse thinks that funding is inappropriate she needs to set up a DST.

She cannot lawfully do a DST on her own.

Filling in a DST form is not completing a DST.

DSTs require evidence gathering from other clinicians involved such as GP and neurologist. For that reason alone the review cannot be a DST.

[Satt2015 in reply to Kevin_1]

Thanks k!

Your a world of information x

[Kevin_1 in reply to Satt2015]

Adding Fast Track is for:

"A rapidly deteriorating condition that may be entering a terminal phase."

[doglington in reply to Kevin_1]

Thats how it was for Chris. They reassured me that I wouldn't need to worry about the assessment. It was a formality.

He died before it happened and, of course may vary with different authorities. I want to say " don't worry " but there are too many upsetting stories. So, I've got everything crossed for you !!!

Jean xxx

[jmoffat]

hi kevin

very interesting

do you know----

what is the relationship between CHC and PIP -ie personal independence payment

Also are they means tested

[Kevin_1 in reply to jmoffat]

Hi Jim

They are completely independent and receiving one does not affect the other.

Neither are means tested.

However to receive PIP one needs to meet tthe eligeability criteria.

gov.uk/pip/eligibility

You might also like to look at

Attendance Allowance - for age 65 and over

gov.uk/attendance-allowance... - if the person cared for is under 65.

And

Carers Allowance

gov.uk/carers-allowance/eli...

Some good news

[Kevin_1 in reply to jmoffat]

Adding

Folk are frequently turned down for PIP, but on appeal it's most often granted... appeals are easy and independent.

Always appeal PIP!

Unless you got it

[Ratcliffe]

For anyone who has been through this and lost their funding, the local councils often have a team that operate independently of their employer and exist purely to set up appeals for benefits etc. Leicester certainly has one of these teams as they share the office we are based in.

Next time I'm in the main office I'll ask whether theatre able to get involved in chc stuff...

[NanBabs]

Thank you again Kevin,

Good information as usual. You include several salient points which I will include in my request for the IRP.

xx

[Kevin_1]

Thanks

Good luck NanB

[maggie4]

I don’t usually post although I follow the posts daily. I felt it worth picking up on comments about pip with a warning. I have been through the process with my husband who has PSP but at the point of assessment was diagnosed with Parkinson’s. as part of his condition he has a false perseptive of what he is capable of and in those early days I felt very uncomfortable correcting him. (I have since learnt my lesson) because of this we lost out on the higher mobility element and nobody told me that if that wasn’t awarded before 65 you never get it. So hard as it is, for any assessment speak up and always look at worst days.