Sign in to follow this  
Followers 0
VINTAGEPAINT

CHC now being withdrawn - advice sought

5 posts in this topic

Looking for some guidance please on next moves. My Mum was granted CHC in 2013 and as a result was moved to a nursing home which can manage her needs.Following her latest review in August at which she scored higher than previous assessments - 1 severe, several highs and moderates the CCG now want to take her to FNC plus continence payment only. Throughout the review they referred to "internal guidelines" relating to National Framework - these seem to be far more onerous. Under pressure from my solicitor they have now agreed to give us a copy of these. Social Services did not attend - I believe that they thought that Mum's needs were such that CHC would continue. However, we have at this point no knowledge of the panel discussion and minutes which led to this decision. I assume that our next option is IRP? However, I fail to see how we can argue successfully when we have no idea of how they reached their decision. Would a FOI or Data Protection Request release these minutes?

Of course the agenda is always budget reduction and we knew that the decision was probably made in the car park but I'm not quite sure where we should go from here - Mum's scores have increased and I find it impossible to understand how she can now be removed from CHC after 3 years?

Any advice or suggestions gratefully received - very stressful

Share this post


Link to post
Share on other sites

Hello,
My name is David, and I am Admin on the site. 
I have never seen "internal guidelines". I'm impressed your if lawyers can get a copy.
Do you know the scoring, if not I can send you a sheet of each of the domains and how they should be scored?
If CCH is withdrawn, you will be told of the Appeal options, however, if your mum is as you describe, I cannot see how CHC can be lawfully withdrawn.
If you want to pm me anything, maybe I can offer a deeper insight.
As far as I am concerned, based on the facts you have stated, either CCH was granted in error initially, or there is an "abuse of process", however the remedies are out of the reach of most of us. 
Sorry to be negative-lets see the so called"Internal guidelines and how they vary from the decided Court Cases 
David

Share this post


Link to post
Share on other sites

We have copies of all assessments and scores and I have been present for all - my solicitor at last two too - at last ASSESSMENT Mum scored 1 severe several highs and the rest moderate - Scores in nutrition and skin are in dispute as they should be higher according to evidence and DST. Scores higher than earlier assessments. The current situation is that they are supposed to be releasing copies of these "internal guidelines" which were referred to throughout assessment but as yet not seen. They have also been requested to provide complete minutes of the "panel review meeting" at which they decided that Mum should be downgraded to FNC - again yet to appear. I fail to see how we can go to IRP without knowing the basis upon which they are trying to remove CHC. To have an internal document alongside National Framework would appear to be unlawful. If we get a copy I will share. Such documents might be in existence all over the country.

Share this post


Link to post
Share on other sites

Hi,

I am sorry to read of the strain you are under. As you say the facts are not only unfair, but I suspect unlawful.
I am intrigued about the "internal documents" as I wonder if the local CCG has updated their local guidance as the CHC National Framework,November 2012 at page 83 gives "guidance on limits can be put on individual choice. The Framework ( paragraph 167 ) allows "a coach and horses" though the spirit of Coughlan as it places the CCG in the position to consider value for money when assessing appropriateness of needs. 
What I suspect is happening is Continuing Health Care Packages of Care are being moved from individual CHC plans onto a standards based NHS Standards Contract https://www.england.nhs.uk/nhs-standard-contract/17-18/
Here is an example of an "Internal Document" 
http://www.westnorfolkccg.nhs.uk/sites/default/files/pdf/Policy%20NHS%20CHC%20Contracts%20Nursing%20%26%20Residential%20.pdf
I wonder if in your case this is botched administration causing you anxiety or a genuine attempt to remove CHC. If the latter, it has to be fought. 
Could you PM (if you wish) the name of the lawyers. There are very few of us who live and breath The Care Act 2014 with a sub specialty interest in protecting the Coughlan test of a Primary Health Care Need. I would be interested in communicating on a non client specific level with any other practitioner as I am sensing the Dept of Health are changing the ground rules without publishing this fact. 
The facts you present are not uncommon to me, and I want to see if other practitioners are seeing the same.

Share this post


Link to post
Share on other sites
Guest
You are commenting as a guest. If you have an account, please sign in.
Reply to this topic...

×   You have pasted content with formatting.   Remove formatting

  Only 75 emoticons maximum are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

Sign in to follow this  
Followers 0