To be shocked that Derek Draper didn’t qualify for NHS Continuing Healthcare

[Mum1976Mum]

Just sat down to watch the latest Kate Garraway documentary. I am absolutely shocked that Derek didn’t qualify for NHS Continuing Healthcare funding as his needs weren’t deemed high enough. This funding isn’t means tested so how much money they have isn’t relevant.

I have some experience of this as we had to claim for my grandad about 8 years ago. He had sarcoma and had to have his leg amputated. He had a prosthesis fitted and was actually pretty active! He could do a lot of things for himself but struggled with self care (showering) and he qualified for the funding.

I honestly thought that, should the worst happen, and someone needed a substantial amount of care that they would qualify. Watching the documentary, Derek needed help with absolutely everything! How on earth did he not qualify?

Couldn't agree more!!

My df didn't qualify despite having aggressive cancer which the care home were concerned about managing and needing help with feeding etc. And the assessors recommended CHC was awarded but the panel turned it down. We used a legal firm to identify grounds for appeal, wrote the appeal ourselves and won. We got a 6 month refund then they reassessed and said no longer eligible so had to pay again. And he had got worse in that time. Could have appealed again but he was actually dying by then so we left it and accepted it left my dm with less to pay for her care when the time comes.
The system is so wrong, people who really need nursing care don't get it.

None of this is any surprise to me, sadness but not surprise.

The definition is supposed to be something like if the lack of that care detrimentally impacts your health in medical terms - whilst in my opinion leaving someone who is incontinent would seriously impact them physically for example actually this has become quite a high threshold in reality.
My mum paid for 2.5 years for ‘social’ care calls with no mobility and a range of meds and conditions - but only when returning from hospital with ‘days’ left on EOL care was switched to CHC. However as she lasted longer than days we were pending a review to check if she needed the CHC funding - she needed support on every function to live and carers to ensure basic care of her body needs were met! Further I am still disputing the bills received from council for Nov/Dec for ‘social’ care as apparently the night calls she always had were not switched to CHC and maybe never should have been in their opinion.
It’s obviously all down to funding, pressures on the NHS etc basically.

That's as maybe but I think she is doing a good thing highlighting how broken the system is and how difficult it is to navigate. Because the money aside it is horrifically difficult.

The Panorama on Hillingdon and bankruptcy

www.bbc.co.uk/iplayer/episode/m001xgql/panorama-paying-more-for-less-councils-in-crisis

@Wakemeup20 yeah I kind of got the same feeling. I'm Scotland so things are different here.

A patient like Derek would most likely qualify for a full package of care at home which would be 2 carers coming 4 times a day to do meds/am wash/skin integrity/set up PEG feed. If his care needs increased beyond this he would need 24 hour care which would be a care home (around £750 pw) or nursing home if he had nursing needs (around £850pw). People tell me it's more around the £1k pw mark.

£16k pm would surely pay for 2 staff providing 24 hour care in the home.

...why? we voted for this, all opposition parties told the electorate that the Tories wouldn't properly fund public services and have no interest in the NHS, we know this because they ran it down pre 1997, they even tried to sell off the NHS.

We also voted for Brexit that robs the NHS of equivalently qualified HCPs instead replacing them with non EU poorly trained and lower English standards.

As much as i/we could blame the Tories for all of this, its not them, its the UK electorate, who consistently vote for any sort of tax cut than properly funded services.

If a Local Authority has to pay £1,000,000 per year for one school place for a severely disabled child, there is going to be little in the pot for anything else. The care bills are increasing all the time. Due in part to immigration, Hillingdon's population has gone up in one year by 10% and is set to rise further. School budgets are cut to the bone. There is no money for Early Years support. Every area is affected.
It is an impossible situation for many Local Authorities.

It really does seem this way, and its terrifying. Also I don't understand how people are failing to realise that a strong support system for the disabled is literally enlightened self interest. I seem to be a pretty healthy person. Pretty fit, eat healthy and exercise, never had any serious illnesses, rarely get colds/viruses. Well, a few years ago I was in an accident that resulted in oxygen to my brain being briefly compromised. I was in a coma for a couple of days (apparently, I don't remember any of this) and my family were told that I would probably wake up, but they didn't know what state I'd be in. As it turns out, I was fine. I lost a few days of memory, but that's all. However, it was entirely possible that I could have been a fit and well youngish woman one day, and severely and permanently disabled the next. This could happen to any of us at any time.

Kate Garraway is a multi millionaire. I don't feel bed that she had to pay for his care when people who cannot afford private healthcare are dying because they can't access NHS treatments

Well, i live in an area where there is little to no immigration & its exactly the same.
We ve an NHS Parkinsons Nurse who lives in the village, her list of patients is over 1000, she gets to see sometimes just 1 patient in a day due to excessive travelling.

As a country we always go for parties that offer tax cuts, even at the expense of our military defence, let alone public services.

I have a relative who is a Headteacher in a London Primary School. A third of the students at her school have some form of SEND. There isn't the money to properly support them.
I agree about BREXIT. The damage it has done to our society is immeasurable. No more degree educated, English speaking workers from Europe. Instead the Government is recruiting from the rest of the of the world and legally bringing in 600,000 migrant workers who need housing and access to the NHS etc. It is why Hillingdon is overwhelmed. Brexiteers have wrecked so much about the UK.

Obviously, workers recruited from overseas need housing, medical care etc but the numbers add another layer of demand.
I feel so sorry for a Labour Government who will be expected to work miracles with empty coffers and greater levels of unemployment than the UK has seen in a long time.

It could happen to any of us at any time. That doesn’t negate the fact that it’s hideously expensive.

At the moment, there is no money around to pay for it. Magic money tree and all that.

I think there’d be more money if we weren’t paying panels of people to avoid paying out for continuing care.

Thing is, good care costs. DF was at home with DM and in a bad way. Regular visits from carers who weren’t allowed to stop/catch him if he fell. Medication DM was reluctant to give him. He was taken into the hospice where he improved no end and they had to discharge him to a care home as he outstayed his allotted time. They had to make a case for continuing care and weren’t sure if he’d get it. And we all knew what would happen if he was moved.

As it was, he took a turn for the worse and stayed put. God bless the hospice and all at it.

Wish we could have that kind of care everywhere, for everyone.

I do think there's an element of human judgement, and if you can pay, they find a way of making you. Derek could pay, so he did. My FIL was quite wealthy but bed bound in a nursing home, he didn't qualify. My father, who did need nursing care but was definitely not in as great a need as my FIL, did qualify. He didn't have much in the way of savings at all and no property, he was just living on the state pension, so I strongly suspect individual finances play a big part in whether you qualify or not. There's an element of rationing going on that is not officially acknowledged, but it's definitely there. Until social care is actually properly funded, I don't think there's much alternative.

The system it seems is different here in Scotland, but it's still not great.

The care at home service is 'free' however it's pitifully under staffed and provides only very basic care (essentially just showering/bathing, toileting and heating food). I think the absolute maximum it provides (for free) is 4 x 45 minute visits per day, so a maximum of 3 hours per day. I think you'd have to be severely disabled to get anything like that though, the norm is a 15 minute visit.

Bed blocking is a huge issue in Scotland too, it can take weeks/months to get these 'care' packages in place (an existing care package is cancelled the moment a person is admitted to hospital, even if it's likely to be a short stay, and they're treated as a new applicant).

There is 2 pots though CHC and social

we get 40 hours from CHC and additional social package of 10 hours from social services - they are 2 Separate things
for example a lot of the children here with packages that have LD / low functioning autism/ mobility / nueo etc are under social care not the CHC.

@Wakemeup20
At the time I was assessing this was the criteria in Wiltshire.

@SloaneStreetVandal that’s crazy and isn’t the case here thankfully or we would be screwed, we have never pay our package during a hospital admission.

The CHC system is a joke. Every time you hear about bed blockers, and the fault is social care, think about how social care went from helping people who needed help with everyday activities to live in the community but now is (unlawfully) providing complex healthcare to severely ill and dying people in the community. If there is an investigative journalist out there, find out how many CHC cases get past at the multidisciplinary team meetings but get declined at a ‘quality’ panel. Really difficult to investigate though because the way it is designed means that health professionals can sit around a table and minimise brilliant well managed care until they can get out of paying for it. That probably Kate Garraway’s situation. Provided amazing care. Well managed need is still a need though and someone on a PEG isn’t social care. What a joke.

I don't know if this has been said but it relates to how complex your medical needs are or at least that is how the assessment works out. So someone bed bound, unable to walk, needing spoons fed etc but whose needs are stable and predictable and can be managed by a carer (not a nurse) doesn't qualify. But I've seen someone who was fully mobile, capacited, had a volunteering job but also have severe, unpredictable epilepsy did qualify. In their case they had unpredictable seizures that left them unable to breathe which required immediate attention from a a highly trained staff member. But yes, the system is broken. I don't think it should be just about CHC but reviewing whole of social care so CHC doesn't seem like the holy grail.

I work in Adult Social Care at my local LA.

It's not the case that no one is getting CHC funding anymore. We get about two-three people per week awarded it.

As an LA, our central government funding has been slashed dramatically since 2010. The proportion of funding we get directly from central government is much, much smaller than it used to be, leaving us more reliant on Council tax.

At the same time, we have an aging population with increasingly complex needs. It's not immigrants who are putting pressure on the system. It's Mabel who is British, 93, who thanks to our amazing NHS, has survived numerous health complaints that would have killed her 40 years ago, but have left her unable to manage her personal care. The immigrants are the ones caring for her because British people are reluctant to take on the jobs, in part because it's low paid and partly due to the stigma associated with it.

Mabel has saved all her life, got a nice house when housing costs meant almost anyone could get on the ladder. Who should pay for her care that costs £1000s per year? If we say we want the government to pay for it, then we need to fund Local Authorities properly. And that money inevitably comes from the tax payer.

If the money is to come from the tax payer, then are you all willing to pay more tax to fund it so that Mabel's children can inherit her house? I'm not.

Yes some care homes are making large profits and this needs to be addressed. But that's a drop in the ocean compared to just how much social care is costing the country as a whole. And some homes are going bust because they're having to spend so much money on agency staff that it's not sustainable.

It would help if funding was transparent but it isn't . As @Hayliebells explained, funding is generally given for those who don't have assets, which for many people is owning a house. At the other end of the spectrum, two of the richest families I know had the funds to take the Local Authority to court and challenge them in a lengthy legal battle. The Local Authority backed down. It could not afforded a court battle.
The greater number of people who choose not to work and so don't pay taxes, the less money there is. The news covered bankruptcy last night and how easy it is for those without assets to write off debts of £500,000. Money has to come from somewhere and there are plenty of posters who agree in magic money trees.

Kindly, I doubt this is the case. If your father had not have qualified and had no money, the Local Authority would have had to pick up his care. Im my experience, the ICB (who fund CHC) give zero craps about who will pay, as long as it's not them. So they don't give it to people as they have less money. It is essentially rationed though with a very high bar to get it.