By Rosalind Hughes, founder of Just Caring Legal
As part of emergency Coronavirus legislation in March, the government suspended the requirement for NHS Clinical Commissioning Groups to carry out their NHS CHC processes. People leaving hospital during this period received emergency Covid-19 funding to allow for timely discharge into care homes. But at the end of August, as the virus seemed to be contained, CCGs were told to get back to business as usual. This meant tackling the enormous backlog of NHS CHC assessments, reviews and appeals that had been shelved since March. As predicted, the current climate of rushed decision-making means more people than ever are slipping through the net. So if your relative is having their initial Covid care funding withdrawn, here are three things that should not happen.
They should not be told they need to start paying for care once Covid care funding is withdrawn
No. This may well not be true, even if your relative is a millionaire! A relative who has recently been discharged from hospital with Covid care funding may well have a primary health need that necessitates high levels of care. That could be because of the effects of Covid 19 itself, or a stroke, or Parkinsons, or severe dementia. In this scenario there is care funding available via the NHS. It is called NHS Continuing Healthcare (CHC) and it pays all essential care fees for the individual in full. This is the case whether they are in a care home or have carers in their own home. It is not means tested but is available to all, regardless of ability to pay. A full multi-disciplinary assessment must be carried out before funding can be withdrawn in any event.
You should not be told they need a financial assessment before any care assessment takes place
It bears repeating. It is NOT in many cases a person’s savings or assets that determine whether they have to pay for care. NHS CHC is paid to all those who are eligible, regardless of what assets or savings they have. If your relative has had Covid care funding withdrawn but has significant ongoing care needs due to health issues then these should be assessed first. This is done via the NHS CHC eligibility assessment, which is made up of several stages. If your relative’s care needs are high and complex, they may well go beyond that for which a local authority can legally take responsibility. So it is vital that those needs are thoroughly assessed before going down the means-test route.
You should not be told an NHS CHC assessment has been done and they don’t qualify
NHS CHC assessments should never happen behind closed doors. The National Framework for NHS CHC makes clear that relatives should be invited to attend. You must be given the chance to have a full input into the process. We have won six-figure refunds for those whose assessments have not been carried out in this way. More and more relatives are being told they are not entitled to even a checklist, the first screening stage in the NHS CHC assessment process. The important thing to remember is that you can challenge decisions with evidence-based arguments. You know your relative best. You know their medical history, their ongoing problems, their significant care needs. However, in the current climate it can be even tougher to get the assessment you are entitled to.
This is where Just Caring Legal can help. Our specialist medico-legal knowledge allows us to challenge NHS CHC assessment decisions that are not supported by sufficient evidence. As one successful client put it: “The process of getting CHC funding is just ridiculous – no wonder so many give up. Without the support from Rosalind and her in-depth knowledge, we would have given up.” So don’t give up. Pick the phone up instead.