The NHS is responsible for paying for people in care that are deemed to have a health need but with experience, we have found that the NHS avoid their duties thereby avoiding funding people’s care and instead, the person in care has to use their assets to fund their care.
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Within the limited law on community care, there is an obligation of good professional practice. This is provided in the form of guidance by the Department of Health. These core values include
- Dignity and integrity – When assessing a person the NHS must take into account the person’s feelings, wishes, dignity and quality of life
- Flexibility – There is no rigid laws and the NHS must account for exceptional needs
- Low thresholds for assessment – The initial screening procedure (known as the NHS Checklist) must not be restrictive
- Assessment valuable in its own right – The assessment is useful and a potential entitlement in its own right
- Waiting times – People should not be kept waiting for a substantial period for a decision
- Preferences – The person’s preference should be taken into account
- Individual assessments – Each assessment should ensure that the person is assessed individually and attentively
- Accurate letters – When informing a person of a decision the NHS should provide an accurate and easy reading letter of outcome
- Explanation for decisions – When providing a decision, especially a negative outcome, the NHS should be explicit.
As well as the above core values, the NHS must abide good administration in relation to assessments. It is common for the NHS to bypass the good administration proverbs of the Department of Health guidelines.
The General Social Care Council’s Code of Practice states that a professional must;
- Treat each person as an individual
- Respect and promote individual views and wishes
- Support people’s right to control their own lives
- Respect and maintain dignity and privacy
- Promote equal opportunities.
The financial constraint on the NHS means that such good practice is difficult to follow.
By following the above, the NHS should come to a fair decision after completing an assessment. However, there is much case law to the contrary. Families can find it difficult to have their voice heard. Failings are usually only exposed by the Courts.
After cases have gone to Court the most common issues that arise are;
- Misplaced reliance on panels – When the NHS completes their assessments; the case is given to a Multi-Disciplinary Panel who makes a recommendation. In cases, the NHS has not completed the assessment fully meaning the Multi-Disciplinary Panel cannot make a fair decision.
- Not considering all relevant factors – Sometimes the NHS can make a decision without taking the relevant information into account. For example, the NHS should obtain all relevant health and social care records before completing the Decision Support Tool but this is often ignored meaning the assessment is flawed.
- Predetermined decisions – Especially with the pressure of lack of funding, before assessments are completed the NHS may have already made the decision and approach the assessment with a closed mind.
As a representative of a family member in care, you may request a NHS Checklist but be disheartened when professionals involved the care state that they will not be found eligible for either Funded Nursing Care Contribution (providing a contribution towards the care) or NHS Continuing Healthcare (covering full cost of care). However, you should not back down and someone should not comment on the health needs without these assessments taking place.
It is common for families to believe the response of the professionals and not continue with the NHS assessments but it is vital that you do. This is especially important if your relative resides in a nursing home as it is clear that they require some form of health care rather than social care.
We have found that the NHS try to brush off most requests for the NHS assessments but when these assessments are completed, many people are actually found eligible for either Funded Nursing Care Contribution or NHS Continuing Healthcare.