The Daily Telegraph - Saturday - Money
‘I am sure they are trying to avoid funding and make it difficult’
Maria Butler’s increasingly complicated care needs eventually led her family to apply for continuing healthcare. The 84-year-old has severe Alzheimer’s, which can sometimes lead to her becoming confused and aggressive.
But, despite having a psychotic episode, which involved her beating the walls of her room during one of her assessments, she was deemed ineligible for funding six times.
Her four children, Jim, Sylvia, Richard and John, went through the full complaints process, with assistance from Farley Dwek, and, after a review by NHS England, were paid a total of £93,359 – £84,895 for the cost of care plus interest. Maria is now fully funded, but the whole process took two-and-a-half years.
Jim Butler, 61, who lives in Rushden, Northants, said: “My sister and I have sat through several of these assessments and you are treated like a nonentity, a non-person almost. I am sure they are trying to avoid funding and make it as difficult as possible.
“If I wasn’t retired this would have been an impossible task because it took up so much time. When the review comes it’s even more expensive for the NHS because our payout included interest, so it’s not like this is a cost saving.”
Mr Winter said aworrying a worrying number of people rejected at the initial assessment stage were unaware that at they could challenge the he decision. The first step to any continuing healthcare application is a “checklist” assessment, in which an assessor will see if the person in need of care satisfies enough criteria for full funding. Assessors will use a national framework to make this decision, although there have been reports of geogr geographical variation in its application. application If funding is rejected at this stage, you can ask for a reassessment. assess If y you are still r rejected you can take your case to the appeal panel in your area via the CCG. You must do this within six months of your rejection and the CCG then has three months to make a decision.
If this appeal is also rejected you can request a review from NHS England, which must conduct a hearing within three months and give you a funding decision six weeks after that.
The only option beyond this is the Parliamentary & Health Service Ombudsman. The letter from NHS England with your funding decision must include details of how to contact the ombudsman.