We explain why we believe it is advantageous to use a continuing healthcare specialist.
Recently we published a blog outlining our concerns over the growing number of firms claiming to be continuing healthcare ‘experts’ but today we argue why – armed with the knowledge of what to look for – we believe it is advantageous to use a specialist. (Read our previous blog ‘Instructing continuing healthcare funding experts – how to avoid the pitfalls‘)
At Compass CHC, we are contacted on a daily basis by individuals from across England and Wales who require assistance with NHS continuing healthcare funding. Whilst some are at the start of their funding journey, many have been battling with the minefield that is continuing healthcare funding for months or, worse still, years and have reached a state of exhaustion with a process so complex that – incredibly – 39% of NHS professionals also reported finding complicated (CHC Alliance, ‘Continuing to Care’ report).
Some clients are so bogged down under the weight of paperwork and confusing terminology that they simply don’t know how to move forward.
Our team of continuing healthcare experts at Compass CHC, headed up by Managing Director Tim Davies LLB and comprising lawyers (non-practising) and clinicians (including nurses, tissue viability specialists and pharmacists), review and consider medical evidence from a clinical perspective before drafting reasoned arguments to the NHS which identify an individual’s entitlement to continuing healthcare funding by cross-referring the medical evidence to the National Framework for continuing healthcare criteria.
NHS professionals use the National Framework – which was introduced to ensure continuing healthcare is implemented consistently across the country – to make decisions about a patient’s eligibility for continuing healthcare funding. However, the CHC Alliance (a group of 13 organisations who believe NHS continuing healthcare needs to improve) reports that ‘despite the National Framework being in place, some local decision makers appear to regard it as guidance, choosing which bits they intend to follow’ (page 9, CHC Alliance ‘Continuing to Care Report’). This total disregard for the National Framework and the national variations in successful funding outcomes, forms a major reason for individuals turning to experts who understand the National Framework inside out. At Compass CHC, we know the Framework back to front and we are aware when a continuing healthcare process has not been carried out correctly, or when a CCG (Clinical Commissioning Group) directly contravene the guidelines. We can step in to ensure that a client’s application for continuing healthcare funding is carried out as smoothly and efficiently as possible.
Clients also inform us that the NHS professionals involved in the assessment for continuing healthcare funding didn’t have the specialist knowledge required to be able to apply the DST. All too often funding is refused due to the lack of in-depth condition specific knowledge. In fact, 66% of respondents to the CHC Alliance also reported that ‘the professionals in the assessment did not possess any in-depth knowledge – or knew very little – about the condition the person being assessed was living with’.
Some clients approach us when they need to appeal a continuing healthcare (CHC) funding decision. We hear from individuals who have been waiting for months for the outcome of their appeal whilst continuing to pay for care fees. More often than not, when a family is mentally exhausted and ready to throw in the towel, using a firm of experts allows the family to regroup and pass the burden on to a team dedicated to getting the correct continuing healthcare decision.
At Compass CHC, our advocates are all (non-practising) lawyers specialising exclusively in continuing healthcare funding matters. Compass CHC does not undertake work in any other area which means we have accumulated vast experience attending assessments and appeal hearings at local and NHS England level and we are not distracted by work of other natures.
The key to success when taking on the NHS continuing healthcare professionals is to ensure that you have sufficient expertise in your corner to support you through the process so the correct outcome is reached.
Summary: what is continuing healthcare funding and why will instructing an expert help?
NHS continuing healthcare (or NHS CHC) is free healthcare provided by the NHS to individuals who have significant healthcare needs; this need must be assessed as complex, substantial and on-going however many take the view that the process for applying is too complicated to navigate and it is currently estimated that of the 150,000 people eligible to the funding, only 60,000 are actually receiving it.
The NHS CHC package of care can be received in any setting outside of hospital including care homes, hospices or even within your own home. A person’s health needs, not their location, is the key factor to receiving continuing healthcare funding.
Importantly, it doesn’t matter what your income is or what savings you have, if you meet the criteria, you are entitled to free NHS CHC funding. Remember, NHS continuing healthcare funding is not means tested and it can cover up to 100% of care costs.
In order to ensure the highest prospect of success in securing NHS continuing healthcare funding, it pays dividends to receive expert advice from industry experts who have a strong track record of securing funding on behalf of their clients. With 78% of NHS professionals reporting that the NHS CHC process is ‘difficult or very difficult’ for patients and their families to understand (CHC Alliance ‘Continuing to Care Report’), it is understandable that so many patients turn to industry experts like Compass CHC for help.
If you have significant ongoing health needs we, at Compass CHC, can help you obtain NHS continuing healthcare funding. Complete our free, confidential assessment today and an expert member of our team will contact you for a no obligation discussion to outline your options.
Author: Tim Davies LLB