Care Fees & Continuing Healthcare (CHC)

 
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When seeking NHS Continuing Healthcare Funding (the funding that pays for care home fees), a Lawyer and a Nurse are the best team you could find. Without expert medical expertise and an intimate working knowledge of the Framework that governs applications for funding,

it is not a level playing field. 

 

Unlike many firms we do not use agency nurses – all our medical knowledge is drawn from within the firm and our advocacy is second to none. We are able to help from the very start of your application or you can call on us if you have started the process yourself and have run into a few problems.

Ideally, we like to be involved from the start and will give you an honest view on whether we believe it is worth making an application.

First step;
Find out if you or your relative are likely to qualify for funding.

There are two options to establish whether you have a potential claim to have your care costs met, we can either:

 

1. Visit you or your relative at home or in the care setting, following which we will advise on the likelihood of being awarded Continuing Healthcare Funding.

2. Alternatively, we can gather information from relevant health professionals, caresettings (in the form of care notes) and speak with the family to establish whetherfunding is likely to be granted.


After we have undertaken the initial review we will provide you with a full report on how we believe any application is likely to result. If there is a good case to be made for funding to be awarded the application process is started by completion of a Checklist Assessment by a District Nurse or someone involved in delivering care. For more detailed information on the Checklist stage, click here.

Second step;
Apply for funding and we’ll advocate for you during the assessment.

If the Checklist indicates that the application should proceed to a full assessment of eligibility, then we will advocate at the assessment which is undertaken by a Registered Nurse and a Representative from Adult Social Care. This is a lengthy assessment designed to test if the applicant can establish that they have a Primary Health Need. For more information on the Decision Support Tool stage click here. 

Third step;
Appeal any decision not to award funding if appropriate.

It is not uncommon for funding to be refused in circumstance which we firmly believe are unjust.  In these cases there are a number of stages of appeal.  Initially the appeal is heard by the Clinical Commissioning Group who first undertook the assessment, if the appeal at this stage is unsuccessful, then a further appeal lies with NHS England before an Independent Review Panel.  For more information on the various appeal stages click here.

 

If Continuing Healthcare Funding is awarded, then it will be reviewed if there is a change in need but it is usually reviewed three months after it being awarded and thereafter every 12 months. If you would like to know more about reviews click here.

 

Reclaiming Care Fees Already Paid...

If you have paid for care fees and suspect that you should not have, you can ask for a retrospective review of eligibility for Continuing Healthcare Funding. If this is successful, any monies that were paid for care within the review period are refunded.

Remember:
You can patch into our expertise at any stage in the process. Many of our clients begin the application themselves and contact us after having run into difficulties.  Whether you are starting from scratch or appealing a decision not to award funding – give us a call and we will happily talk thorough any issues without obligation. Everyone who calls gets help.

If The Situation
Is Urgent...


If the applicant for funding has a ‘Rapidly Declining Condition’, effectively an end of life diagnosis, then funding should be awarded and arrangements put in place for their care within 48 hours - known as ‘Fast Track’ funding. If you would like to read more about this, click here.