Preparation for NHS Continuing Healthcare MDT Assessment?

[DorsetCamping]

I've just taken a call from the CHC team to tell me DM has passed the first stage of CHC assessment and a 'decision making' meeting will now be held 26/2.
I was unaware that the referral had even been made by DM's care home but am really pleased as had been considering applying for some time.

So I firstly have a call scheduled with a 'Nursing Clinician' on the 22nd. followed by an MDT meeting on the 26/2 between myself, Nursing Clinician, Social Worker and a CHC rep.

I obviously want to be as well prepped as possible to present DM's case, so would be really grateful for advice/tips from anyone who has any experience of this process. I'm all too aware that it's nigh on impossible to get CHC so the fact we have made it this far shows me DM has a strong case and I want to do all I can to facilitate it being granted.

Many thanks!

So despite several 'high' and the rest 'moderate' indicators, DM was not considered to have a 'primary health need'.

Unfortunately the nurse at the NH was unable to attend.

Am exhausted and confused by the decision. The meeting lasting nearly 3 hours where each category was discussed in detail and I was naively thinking it was a no brainer as she scored so highly. But then they went on to assess the primary health needs eligibility and concluded within 5 minutes that DM didn't have any and therefore case closed. Very quickly said she would be eligible for FNC and then meeting ended.

Not sure if it's worth appealing but from what I can gather NH don't even reduce their fees by the FNC payment can't really see point in awarding it.

So disappointed for you. Had the nurse at NH been there would it have changed?

Your mum - if already in NH- is likely to already be getting FNC (claimed direct by the NH to CCG). The nursing Home wouldn't have been including that in her care charges to whoever is managing her funds, as it comes direct from local CCG (NHS commissioners). I'd read it as they are reminding you CCG (health) is contributing to her nursing home placement for her nursing needs.

If you feel confused by it all, you can request a full copy of her DST report (as her LPA health and welfare: client reps) from that continuing healthcare (CCG CHC) team. Usually they (CCG) send you a letter of outcome with details of appeal process.

If you look on HMGov website there is plenty of documents on CHC process.

but from what I can gather NH don't even reduce their fees by the FNC payment can't really see point in awarding it. The NH assume at the start that you will get FNC and base their fees on that. Buried in the small print on our contract is a statement that if FNC isn't forthcoming, any nursing requirements will be dealt with by District Nurses not by the nursing home nurses. So the point of getting it is to be able to continue to access the 24hour availability of NH nurses instead of relying on sporadic visits from District Nurses.

AGE UK can refer you to a company to help with the appeals process; one hour of their time is funded by the Government. They were able to give me enough information to confirm my opinion that there was no point in an appeal (less severe needs than you seem to have), which I was rather relieved about, as I was in no state to take on yet another load of paperwork.

So despite several 'high' and the rest 'moderate' indicators, DM was not considered to have a 'primary health need'. They seem to be looking for unpredictability and the need for daily nursing decisions. If a "High" need can be met by a routine intervention it doesn't indicate a primary nursing need.