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In the News: Dying Cancer Patient Loses Health Care Funding After Needs Deemed "Not Severe Enough"

With stories in the news of more terminally ill patients losing their continuing healthcare funding, Compass CHC’s Managing Director Tim Davies has offered his views on the issues.

A former volunteer ambulance driver who is terminally ill with cancer has been told his health needs are “no longer severe enough” to qualify for NHS continuing healthcare funding.

Derek Brickley, 85, has terminal testicular cancer and requires 24-hour nursing and constant pain relief. He is also unable to move or talk coherently, can only be fed liquids and suffers from dementia.

Despite this, his family have had to put his home up for sale and empty his bank account to meet the demand for his £900-a-week care costs, following the decision of a Clinical Commissioning Group in December.

For those who may not be aware, continuing healthcare funding to meet the cost of care is awarded to those with primarily health needs. This occurs where their health needs are classed as being intense, complex or unpredictable in their nature. However, the funding can be lost if a reassessment deems that the needs of the patient are ‘social’ as opposed to primarily ‘health’ related.

If this happens, the sick person will have to cover the cost of care themselves if their assets exceed £23,250. A more detailed explanation of continuing healthcare can be found here.

Mr Brickley was awarded funding to the value of £900 a week when initially assessed in August 2017, which covered his nursing home fees for palliative care in what was to be his final stage of life. But three months later, Mr Brickley was to be reassessed to determine whether he was still eligible for the funding.

The reassessment scored Mr Brickley’s considered 12 domains, including mobility, continence, cognition, behaviour and any nutritional needs. Even though he could no longer move, was on 24-hour pain relief and was rarely lucid, it was decided that he no longer qualified for fully funded continuing healthcare.

A similar story occurred when a vascular dementia sufferer suddenly had his continuing healthcare funding removed suddenly after receiving it for five years.

The condition really started to affect Ernest Smith in 2012, which caused his behaviour to become unpredictable. He was moved into a care home, with his £1,800-a-month fees covered by continuing healthcare funding.

Since then, Mr Smith’s condition has deteriorated dramatically, meaning he can no longer walk, feed himself or recognise his family. He also becomes very aggressive and agitated when touched. But despite this, his was deemed as no longer suitable to receive continuing healthcare funding.

According to figures from Freedom of Information requests to Clinical Commissioning Groups – which are responsible for allocating continuing healthcare funding – it shows that between 2013 and 2016, there was a 300% increase in the number of people who had their funding taken away from them following a reassessment.

Speaking of these recent events, Tim Davies, Managing Director of Compass CHC, has had his say:

“Unfortunately, the examples shown follow an increasing pattern we have noted across England and Wales that the bar of eligibility for entitlement to continuing healthcare funding is being raised without justification or explanation. The National Framework for continuing healthcare funding is a clear set of procedures that should be followed by Clinical Commissioning Groups, yet our experience is that these procedures are regularly ignored.

“The concept of continuing healthcare follows that of the NHS as a whole that healthcare should be free to all at the point of delivery, regardless of the financial position of the individual.  Where an individual has health needs that are so complex, intense or unpredictable that they require full time care, continuing healthcare funding should be available to meet the care costs. All too often this is a right that is being incorrectly denied to the public and it must be challenged.”

If you have any questions regarding continuing healthcare funding and the entitlement to the assessment process, or indeed any queries relating to continuing healthcare funding you should not hesitate to contact a member of the Compass CHC team for a free, no obligation discussion.

Author: Tim Davies LLB

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