Your relative may have been assessed for NHS Continuing Healthcare but the outcome is that they do not meet the eligibility for the NHS to fund the cost of care.
You do have the right to appeal this decision and we can work with you to establish whether the NHS made the incorrect decision.
Please call me for a no obligation chat on 01536 276300 or 01536 311690 or use our online enquiry form.
If your relative is in a care home setting or leaving Hospital and the relevant NHS Continuing Healthcare assessments have been completed, a negative outcome (either at the NHS Checklist or NHS Decision Support Tool) may have been reached. You have the right to appeal a decision.
The NHS are under a duty to provide the person (and representatives if appropriate) with clear details of how to appeal a decision but from experience, the NHS rarely do so. They impose deadlines, usually 6 months to raise an appeal.
One of the most important things you can do as your relative’s representative is to keep a written record of what happens at every stage of the assessment. You may not realise how much you will need to rely on it should you decide to appeal a decision.
Notes about your relative’s state of health should be kept, and any changes in their care needs recorded. Usually, you know your relative more than anyone else, so your opinion in the process (and appeal process) is crucial. You should attend assessments and ask to be copied in on all correspondence.
The main reasons for appealing the assessments include;
- All relevant information not taken into account
- Care needs not recorded
- Family not informed of the assessments
- Family not invited to attend assessments
- Refusal of eligibility
- Incorrectly applying the NHS guidance.
If you decide to appeal a decision we can help in several ways;
- Provide a report detailing all of the relevant information that should be taken into account and providing our view of your chance of success. You can then appeal directly using this report during the appeal process.
- Instructing us to complete the entire appeal.
- If found successful, instructing us to complete a retrospective review to determine how far back the care fees should be reimbursed.