CHC delays

I’ve pulled a muscle in my back from all the crying I’ve done in the last few days. The doctors don’t seem worried at all about my dad but I have a VERY strong feeling that he is nearing the end of his life. He sleeps most of the day, hardly has the energy or the will to eat anything other than the hospital’s chocolate mousse or ice-cream, he phases in and out of reality and yesterday his fingers were blue & he had developed chills. All they seem to do in hospital is daily blood & urine tests & say “review again tomorrow”.

He went into the nursing home 11th March and I was told the FNC would be applied for automatically and it usually goes straight through but I’d be told if there was any issue. I never thought anymore about it. Last Friday I got a letter giving me the review date of next week and that CHC eligibility would be assessed first. Knowing how long elderly people seem to stay in hospital I contacted them yesterday to ask if they can do it while he’s still there & today I’ve been told it’s been postponed till mid-July. I have no doubt that he is now eligible even if he suddenly recovers from this current ‘infection’ but unlike AA / PIP etc, the claim doesn’t start from the date you apply. He can’t be assessed while in hospital, or when he comes out if he’s not optimised. We all know how once they start on this track he can go in and out of hospital like a yo yo so the chances are that this claim is never going to be assessed. I have said this is not fair and he is paying £1500 a week when he shouldn’t be paying anything and they can just keep kicking the can down the road. The date was originally set for 1st June (unbeknown to me) but had to be cancelled because of him being in hospital before.

Is there anything I can do to fight this? I fail to see why this can’t be backdated to at least 1st June which is both the original appointment date and also the date he came out of hospital last time. How do you ever prove that their current condition is permanent, especially when the hospital don’t even know what’s wrong??

As always, thanks in advance x

Dear Henrys Cat

I would suggest you contact our Helpline for advice - Our Telephone Helpline is available on 0808 808 7777 from Monday to Friday, 9am – 6pm or you can contact us by email (advice@carersuk.org)

good luck
Ingrid

Thanks Ingrid, I will email them.

I’ve spoken to the clinical lead on the assessment team and to the nursing home manager. They’ve both basically told me there is no chance of anything happening anyway. Many people apparently never get the chance to apply for it because the chances are that at this point you’ll be pretty poorly and very liable to change / deterioration / hospitalisation. There are delays in getting appointments and then of course actually being reviewed, all of which is dependent on those dates tying up with enough of a period of stability so that they can assess where the caree is now. I’ve also got the situation now where the nursing home is ‘reluctant’ to take him back, and they are asking for a decent enough gap (like a couple of weeks) so that they can assess him first in order to give the review team an accurate picture. It really feels like the system is set up to fail people.

Hi Henry’s Cat. Take a look here: NHS continuing healthcare - NHS

There are useful links that might help. Especially over timelines. Also remember: they are not allowed to prejudge the situation.

Thanks Charles. We’re totally stuck. I can’t get him out of hospital but nobody knows what they are looking for. The SW at the hospital won’t get involved until he is ready for discharge, the community SW won’t get involved until he’s out of hospital AND discharged from the hospital SW, which may then mean he has to go back on their list with another wait. I can’t see how he’s ever going to be able to get the assessment.

NHS Policy was that they started planning discharge from the day of admission, however because of Covid some rules seem to have been changed, others simply forgotten about. Assessment for Continuing Healthcare was only supposed to happen when ready for discharge, but now there is a “discharge to assess” policy, which to me is a load of rubbish. How can you even think of sending an elderly, disabled, not going to get better only worse, patient home without ensuring everything is in place. After all, they know very well from the care they have been providing in hospital what that person will need when out of hospital!
Our local Social Services has a dedicated “Hospital Discharge Team”.

I’ve dealt with our local hospital discharge team before (and the associated social worker) and I wasn’t impressed then. They’ve told me this time (again) that they don’t get involved until the person is medically optimised. Dad is an ‘easy’ discharge in the sense that theoretically he can’t get any worse in terms of his need for care because he’s already got a nursing home place. However, the reality of that is that the home (understandably) need 10 days after a positive covid result (which we’ve now had), a negative covid result (he’s still positive this morning), and seemingly unlike the families they can say “we won’t take him until x or y have been achieved”. The hospital is now under a Critical Incident and I know they don’t have the staff to give him what he needs to get better enough for long enough to get out where he can be looked after more intensely.