- 12th November 2015
- Posted by: Seatons Solicitors
- Category: Articles, Residential Care Fees
How does the Continuing Healthcare assessment process work?
There have been many recent reports that hundreds of families have incorrectly been denied NHS Continuing Healthcare Funding. If a person has sufficient health needs, then the NHS are responsible for covering the entire cost of care including accommodation.
However health and social care authorities often provide misleading information to families about the process and the assessment criteria.
Ideally all assessors would be adequately trained and take note of the National Framework. The National Framework is the Government guidance that the NHS are required to adhere to. Sadly this doesn’t appear to be the case in many instances.
Many people working in hospitals and care homes often seem unaware of NHS Continuing Healthcare and the requirement for a fair and proper assessment. Even if they are aware of it, it often seems that they don’t always understand how it works. This means that people requiring ongoing care are immediately at a disadvantage, as the NHS fail to adhere to their duty of assessing a person and the person pays for their own care.
Starting the process
The Checklist is the first stage of the NHS Continuing Healthcare assessment. This assessment is relatively straightforward. It can be completed by just one person – just ensure that one person has full knowledge of their requirements under the National Framework.
If you are appointed Attorney or are acting on behalf of your relative, you should request to be involved at every stage and provide your input. You should be given reasonable notice of any assessment meetings and full information about the process so you can understand the reasoning for the outcome.
A positive outcome in the Checklist (i.e. if the scores are high enough) does not mean a person is automatically eligible for NHS Continuing Healthcare; it simply means that the person goes through to stage two. This is a known as the full assessment and is much more involved.
If you disagree with the outcome of the Checklist, you can request that it is done again or you can also insist that your relative goes through to stage two, the full assessment, anyway.
Many families report that they are kept in the dark about the assessment process and that assessments are carried out without their knowledge. It can seem that you come under immediate and inappropriate pressure to agree to a financial assessment.
The local authority
The NHS Continuing Healthcare assessment process is managed and completed by the NHS. However, a local authority representative or social worker must be involved in the full assessment (stage two). This is because the local authority must look at whether or not the care is beyond the legal remit they can provide.
Means testing will determine how much you have to pay towards care fees. It is only relevant after the NHS Continuing Healthcare assessment has been completed – not before!
From experience, many families encounter mistakes by the NHS when it comes to the proper NHS Continuing Healthcare funding assessments prior to hospital discharge. A person must be assessed for NHS Continuing Healthcare using the requisite documents before they are discharged so it can be established who is paying for the ongoing care.
Read more about NHS Continuing Healthcare. (can you link this to area on website please)