Meet the Other Phone. Flexible and made to last.

Meet the Other Phone.
Flexible and made to last.

Buy now

Please or to access all these features

Legal matters

Mumsnet has not checked the qualifications of anyone posting here. If you have any legal concerns we suggest you consult a solicitor.

Continuing Health Care - appeal stage 2

2 replies

TynesideBlonde · 06/04/2018 23:22

Does anyone have experience with CHC appeals? My mum has Secondary Progressive Multiple Sclerosis, diagnosed 25 years ago and Alzheimer’s diagnosed 7 years age. She needs 24 hour care and can’t do anything at all for herself. She lives at home with my elderly father and has a significant care package.

CHC has been withdrawn at her last assessment. She is as you would expect in worse health that she was when funding granted 4+ years ago so this has been a huge shock. We will recieve social care funding which amounts to about 20% of her current weekly care cost (which won’t even cover the cost of basic personal care visits (she is incontinent of bowel and bladder so needs 3 x nappy changes a day with 2 x carers (hoist transfers etc) as she is totally immobile.

I have lost the first appeal. Her consultant is clear she has a primary heuualth need (two actually!) and as such should quality.

Any advice would be hugely appreciated.

OP posts:
hatgirl · 06/04/2018 23:50

Although I agree that it sounds like your mum has significant health needs CHC isn't necessarily about how ill someone is, or what diagnosis they have unless they are receiving end of life care in which case they may qualify for the fast track CHC option).

CHC is needs based so a lot of families find that as someone's health deteriorates they can drop out of CHC funding because they no longer have as complex needs as they did previously.

For example someone who is still being transferred from bed to chair/toilet and back again a few times a day and has moving and handling risks associated with those transfers could be argued to have greater complexity of needs than someone who has deteriorated to the extent that they are receiving standard nursing in bed with 3-4 hourly turns in bed.

Another example is people who have behaviour difficulties/wandering etc as part of their Alzheimer's disease may meet the CHC criteria early on when they are still mobile but as the disease progresses and their strength and inclination to resist care/ wander dwindles they no longer have the complexity of needs required to meet the CHC threshold funding even though their 'health' has got worse.

The needs you have described are generally considered to be social care needs rather than health needs. Continence care is considered a health need if it requires oversight of a nurse or health professional to manage it, e.g frequent UTIs, bowler issues requiring manual evacuation, problematic catheters etc. Changing pads 3 times a day can normally be done by social carers.

I do think it's unfair, but the NHS has really toughened up in recent years about very strictly administering the criteria that someone's needs must be of a 'nature, intensity, complexity and unpredictability' that they meet the criteria. Those four words are what you need to focus your appeal round.

If the consultants feel strongly about it then there is no reason why they can't provide evidence for your appeal. I would be very surprised if they do though. Most have absolutely no idea of what CHC funding requirements actually entail.

I assume your mother has already been financially assessed by the local authority? Did the local authority agree with the NHS conclusions that your mother no longer met the criteria for CHC?

Good luck any way, although in my experience most appeals are inly successful if it can shown that there were errors in the way that the process was carried out, rather than the decisions that were made.

whataboutbob · 09/04/2018 17:30

I manage to get CHC for dad and fortunately he never lost it but I was prepared for the eventuality of it being removed and having to appeal. One source of help int he whole process was the organisation Care to be Different. It was set up by a mumsnetter who got CHC for both her parents. I got good advice and support and didn’t even pay, Angela answered my emails with valuable advice. Have a look at their website. Good luck.

New posts on this thread. Refresh page