Thinking of quoting ‘Coughlan’ in your battle for CHC? Think again!
We explain why an internet search often leads to misleading CHC information
It comes as quite a shock to many people, when they discover that social care is not free for everyone.
Like most things in life, we only discover the real facts at a time of crisis, when our lives are turned upside down.
And when it comes to social care, we only find out about its limitations when our loved ones become frail or vulnerable and they need help.
Unlike NHS health care, which is free, the same is not true of social care which is means-tested.
This means if mum or dad need help with things like washing, dressing and feeding – and they have savings of more than £23,250 (or they need to go into residential care and they own their own home) – then they are classed as self-funders and must pay for social care themselves.
This unfair, two-tier system has always created friction. And it’s the reason why so many relatives pursue ‘Continuing Health Care’ in an attempt to protect their loved ones’ savings.
We have written a lot about Continuing Health Care (CHC) and you can find out more about it here.
To quickly recap, if the majority of your relative’s care needs are health-related, then CHC is an option. CHC is not means tested and the NHS will pick up the entire care bill.
Here’s why quoting the ‘Coughlan’ case is unlikely to help you win CHC funding:
Following a landmark Court case back in 1999 – which is referred to as the ‘Pam Coughlan Judgment’ – many people get in touch with us, quoting ‘Coughlan.’
They have usually read about it on the internet and are convinced they can use Coughlan to win or appeal a CHC funding decision.
They believe, not unreasonably, that because their mum or dad’s illness is equal to, or greater than, that of Pam Coughlan, their loved one should also be entitled to CHC.
At Steene Law, we really hate to burst anyone’s bubble. But the sad fact is that, despite what is often found on the internet, the Coughlan case is usually not relevant when arguing with the local Clinical Commissioning Group (CCG) that your loved one deserves to receive CHC funding.
And what makes us really angry is that there are a number of disreputable companies out there that appear happy to perpetuate this myth.
We have heard of some that will eagerly take many thousands of pounds from unsuspecting relatives, promising to fight CHC funding decisions, using the ‘Coughlan argument’.
The sad reality is, that in the vast majority of cases, there will be absolutely no connection between Pam Coughlan’s medical condition and that of many clients’ relatives.
So if a company is promising to fight your CHC claim by using ‘Coughlan case law’ – be very wary indeed.
Why do we say Coughlan is, for the most part, irrelevant?
Actually, it’s not us saying it, it’s the High Court!
Late last year, the High Court made the issue of ‘Coughlan’ very clear indeed when it was asked to rule on a case where the Claimant’s needs were greater than that of Pam Coughlan. Despite this, the Court stated that all cases will be fact specific.
This means that trying to prove whether a person’s disability is equal or greater than Coughlan is not relevant.
Here at Steene Law, we believe in providing the facts rather than empty promises.
Legal fact-checker
And because we are aware that some of these CHC claims companies also read our blog, we are happy to set out the legal facts:
- In the absence of “exceptional circumstances” there is an obligation on a CCG eligibility panel to accept a positive DST recommendation.
- The Court have said that the National Framework is guidance not legally binding. The obligation on a Clinical Commissioning Group is to have regard to the National Framework it does not say the National Framework has to be slavishly followed.
- Despite what any number of forums or other companies may state, the High Court concluded “a failure to adhere to the National Framework Guidance does not amount to unlawfulness.”
If you want factual CHC advice, don’t search the internet – speak to Steene Law
At Steene Law we are able to advise you whether your relative is likely to obtain CHC and guide you through the process.
If you want to discuss the prospects of success, then we are happy to have a free chat.
Call us on 0203 653 0623 for a free, initial telephone conversation. We are available from 8am to 7pm, Monday to Friday.