Vulnerable patients left in limbo over care bills funding

AROUND 25,000 elderly people with conditions like dementia have been left in limbo waiting to find out if crippling care bills of up to £100,000 a year will be funded by the state, The Daily Telegraph can disclose.

Thousands risk being unfairly denied funding for their care after being caught in a “huge” lockdown backlog of applications, lawyers have warned.

In March, health chiefs halted assessments of whether patients could have their care paid for by the NHS, while services focused on the Covid crisis.

The Telegraph can disclose that the six-month suspension has left around 25,000 people waiting to find out if their bills will be funded by the state.

Under national rules, any patient with a significant health problem should have their care and nursing fees paid in full – if the condition is deemed to be the main reason they need such help.

But investigations by The Telegraph have revealed that even before lockdown, authorities had increasingly refused to fund care, claiming that devastating diseases are not severe, or not the primary reason help is needed.

Now experts are warning thousands of patients could be unfairly denied the NHS funds as under-pressure officials rush through the backlog of cases.

Charities said the situation was “extremely worrying”, warning that with many claimants near the end of their lives, “justice delayed” could too often mean “justice denied”.

In many cases, decisions are now being made over the phone, with the assessor never meeting, or even speaking to, the patient or their family, experts said.

Lisa Morgan, a partner with solicitors Hugh James, said she was concerned the rush and pressure to clear cases would “lead to unfair decisions”.

NHS Continuing Healthcare ( CHC) funding pays for care when people need it primarily for a medical problem, like advanced dementia, Parkinson’s or a stroke, rather than simply being frail through old age. It is not means-tested and is separate from the adult social care funded by councils.

Official figures show that take up of funding reached a record low of 48.8 per 50,000 people by the end of June, down from 56.3 in March, and 68.8 five years ago.

There was a five-fold rise between the end of March and end of June in people waiting up to six months for assessment for CHC, up from 286 patients to 1,430. Over the same period, the number of people waiting more than six months for assessment nearly tripled from 273 to 730.

Caroline Abrahams, charity director for Age UK, said: “This backlog of claims is extremely worrying as CHC provides vital funding for some of the people with the greatest health and care needs of all. It’s no surprise the pandemic has slowed down the process of assessment, but since many claimants are likely to be close to the end of their lives, ‘justice delayed’ must sometimes mean that ‘justice really is denied’.”

Hannah Morris, of law firm Simpson Millar, said: “It’s a real concern for families that they are not going to be given a fair hearing. Assessors are supposed to speak to both carers and families, but these are understaffed departments and there’s concern that there’s real risk these steps – which have historically been missed when corners are cut – will be missed again.”

An NHS spokesman said: “In line with government guidelines, NHS Continuing Healthcare assessments restarted on 1 September. All clinical commissioning groups and l ocal authorities are now expected to establish efficient processes to manage referrals deferred between 19 March and 31 August, while maintaining the delivery of high quality assessments.”