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Tim Davies LLB

Compass CHC successfully secures £21,600 refund of care fees

17Without the right support securing NHS continuing healthcare funding can be difficult, so when we take on a case it’s always nice to share the successful outcome

We were contacted by the client, a relative of the patient in question, at the start of February 2017. A Decision Support Tool (DST) was carried out on the patient in early February 2017. Compass CHC was not in attendance at this meeting.

Following a negative funding decision at the DST, we reviewed the care records and drafted appeal representations detailing why we felt that the Decision Support Tool findings were incorrect. (The DST identifies twelve areas of need or ‘domains’ – 11 specific domains and an additional domain for recording needs that don’t immediately fit into the other 11.)

Domain DST Scores Our view 
Behaviour Moderate Moderate
Cognition* Moderate                   High
Psychological Moderate Moderate
Communication Moderate Moderate
Mobility High High
Nutrition High High
Continence Moderate Moderate
Skin Moderate Moderate
Breathing Low Low
Drug therapies* High Severe
Altered States of Consciousness Moderate Moderate

 

Our advocate Andrew Carman attended a local panel hearing in August via telephone conference and argued the case for our client to receive NHS continuing healthcare funding. He outlined Compass CHC’s reasons for disputing the DST scores in both the cognition and the drug therapy domains.

We can confirm that that following Andrew’s intervention the panel agreed with our arguments and the initial decision was overturned with continuing healthcare funding awarded from the date of the original DST in February to the day of the patient’s passing.

In all we have managed to reclaim 18 weeks of incorrectly paid care home fees at £1200 per week totalling £21,600.

For more information on NHS continuing healthcare funding or to view our library of informative video blogs and articles please visit the Compass CHC website which also contains more case studies and client testimonials.

Once we accept instructions to act on a patient’s behalf, our team of continuing healthcare experts, comprising lawyers (non-practising) and clinicians (including nurses, tissue viability specialists and pharmacists) work tirelessly to review and consider all the medical evidence from a clinical perspective before drafting reasoned arguments to the patient’s Clinical Commissioning Group identifying how the individual is entitled to NHS continuing healthcare funding. They do this by cross-referring the medical evidence to the National Framework for continuing healthcare criteria.

Should you, or a relative, have any concerns regarding NHS Continuing Healthcare funding, or you are thinking about starting the funding process, our expert advisors can assist by explaining the ins and outs of what can be a perplexing and complicated process. There is no time limit placed on this free, no obligation consultation. Should you wish to discuss matters further, do not hesitate to contact us directly on 0121 227 8940

Do not delay, contact us today. We specialise in securing funding from day 1 and assisting families with the process from the outset. Don’t wait until a negative decision has been made and it is then necessary to have to appeal the outcome. This can take many months and all the while the patient will be having to pay the cost of their care.

Did you know?

If an individual is approaching the end of their life then a “fast track” Continuing healthcare funding assessment may be appropriate. This enables the individual to receive prompt NHS funding to meet the cost of care at the end of life stage.

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