If your loved one has Dementia and you are fighting for Continuing Health Care funding you need to read this.
From Monday 20 May to Sunday 26 May, it’s Dementia Action Week – a week that aims to raise awareness, take action and improve the lives of people living with dementia.
Currently, in the UK, there are 850,000 people living with dementia and this figure is set to rise to over one million within the next two years.
We understand it is tough enough supporting a person with Dementia without also having to fight for Continuing Health Care (CHC).
What is Continuing Health Care?
If you are granted CHC, the NHS picks up the tab for all your relative’s care costs rather than expecting them to self-fund – something which happens if they have more than £23,250 in assets.
However, the system of allocating CHC is extremely unfair. It’s bad enough having to deal with the daily stress of your loved one’s deteriorating behaviour and failure to recognise you anymore – without having to battle the authorities for care funding.
Why do we know this? Because members of the Steene Law legal team have first-hand experience of dealing with a family member with dementia.
At Steene Law we fight unfair CHC decisions every day. It is shocking that people are wrongly told that their condition means they do not qualify for CHC.
Why is this happening?
The NHS should treat people equally but, sadly, an NHS postcode lottery exists. Depending on the part of the country you live in and which Clinical Commissioning Group (CCG) looks after your area, you may or may not receive CHC.
To make matters worse the forms that social services use, to decide whether a person’s health needs mean they should receive CHC, are a blunt tool – meaning that people who should get free care are being WRONGLY told they don’t qualify for CHC.
Evidence, Evidence, Evidence
Not a day goes by where we’re not asked to review an application for NHS Funding that has been unlawfully declined by a CCG. The family will often ask if it’s worth appealing the decision.
Unfortunately, the process of getting Continuing Health Care (CHC) is not based upon a person’s illness, because dementia itself does not qualify for the State to pay nursing home care fees.
So, what we need to do is show that the effects of the illness fit a legal term called a ‘Primary Health Need’.
The challenge is to prove that your relative has a Primary Health Need, and like everything that’s important in life, it has to be fought for.
Shockingly, sometimes the very people we trust, be it the Local Authority, the NHS or a Care Home don’t always tell the truth, meaning that this non-means tested entitlement is unfairly denied.
To win and keep CHC, it is vital that the family has evidence to support the CHC application.
We advise everyone that if they have a Lasting Power of Attorney for Health & Welfare, they should use this to obtain, at a minimum, the GP notes, copy of the care home records and a copy of any medical reports.
It is also extremely useful to get hold of relevant copies of specialist reports e.g. from the community psychiatric nurse, tissue viability service and the district nurse service.
If your family member is a so-called self-funder and they have been denied CHC even though there is clearly a Primary Health Need, we urge you to call the team at Steene Law.
Where there is insufficient evidence, our experts will check the quality of the records that the care home is keeping.
The number of times we see care or nursing home records that merely describe a person’s daily activities, as opposed to their behaviour – which is often vital to successfully arguing they have a Primary Health Need – is frankly shocking.
If you are watching your family member’s lifetime of savings disappear and they have been refused CHC, call Steene Law on 0203 653 0623 for a free conversation to find out if we can help you overturn the decision.