Continuing Healthcare in Somerset: Care Home Fee Claims

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NHS Continuing Healthcare is a complex area. Solicitor Charlotte Mitchell specialises in helping families recover care home fees where funding has been wrongly refused. In this article she examines the principles relating to funding in Somerset.

 

What is NHS Continuing Healthcare?

Continuing healthcare (sometimes referred to simply as CHC) is care provided and funded by NHS to people with complex ongoing healthcare needs who are not being looked after in hospital.

CHC is usually delivered in a care home setting, but can also be provided by a hospice or a person’s own home. 

Eligibility for Continuing Healthcare

To be eligible for CHC the patient’s main need for care must relate to their health.

The assessment of health need can be highly controversial and it is in this context that many disputes arise.

Applying for Continuing Healthcare

The NHS will carry out an assessment, known as a screening checklist, to establish if a patient is eligible for CHC funding. A patient can request an assessment themselves. Family members or carers can also seek an assessment.

The issue can be raised with a member of the clinical team or a social worker.

The NHS Somerset CCG continuing healthcare team can be contacted directly by telephone on 01935 384024.

The patient will then either undergo a full assessment or be advised that they are not eligible for NHS continuing healthcare.

A Personal Health Budget

Those eligible for funding in Somerset can have a personal health budget, with money being paid to the patient by the NHS to enable them meet their healthcare needs. This gives the patient a greater choice of care.

A personal health budget can take various forms. Payments can be made direct to the patient or to a third party.

Appealing a Continuing Healthcare decision

If a patient (or a family member/carer) disagrees with the NHS funding decision they can raise their concerns with Somerset CCG Patient Advice and Liaison Service (PALS) who will refer the matter to the Somerset continuing healthcare team.

PALS can be contacted at: PALS, NHS Somerset Clinical Commissioning Group, Freepost RRKL-XKSC-ACSG, Yeovil, Somerset BA22 8HR.

Alternatively you can telephone PALS on 0800 0851 067 or send an email to [email protected]

Continuing Healthcare reimbursement (redress)

If an appeal is upheld the patient will receive reimbursement for any care fees paid during periods they were entitled to receive continuing healthcare support.

This is sometimes referred to as a redress payment.

Claims for a redress payment can be made to The Continuing Healthcare Team, NHS Somerset Clinical Commissioning Group, Wynford House, Lufton Way, Yeovil BA22 8HR.NHS.

How we can help you

Continuing Healthcare funding is a complex area. Many people whose applications for funding are turned down consult specialist lawyers like ourselves for advice on challenging the NHS decision.

We are happy to provide free initial guidance. If we feel we can assist then we will let you know what steps can be taken and how the legal fees can be funded – including our popular No Win, No Fee scheme.

Call us on 01823 354545 or email continuing healthcare funding specialist solicitor Charlotte Mitchell at [email protected]