Continuing healthcare being withdrawn

I will certainly ask, the home has been understaffed the entire time Dad has been in there. In fact at one point they were placed in special measures purely on staff numbers. They do a great job all things considered.

I certainly am expected to use my annual leave. I work for one of those wonderful small companies where the owners are also the HR

Quick update. Spoken to the manager of the home who is amazed this has happened and can’t understand why. Everyone involved in his care has said similar.

The only thing anyone has come up with is they don’t have enough money and are making cuts across the board.

The good news is the home are already being very pro-active in assisting with the review and have confirmed that as he is already in receipt of CHC an appeal means that has to continue until the matter is resolved. They have also suggested to really push the fact that is health is very unstable and while he can have ‘good’ days this can turn quickly and with his inability to communicate means he requires round the clock care.

None off which is reassuring my Mum who is in a terrible state, not helped by my Dad questioning who she was and why she was there and the fact the home have had to call the doctor out on two consecutive days for different issues.

Good to hear the home are going to support you. I really hope they will record all issues as proof for the CHC assessment because they will want it.
Oh your poor Mother. It’s very heart breaking situation that is so hard not to take personally. It’s very hard for you too I definitely understand it. Does she visit every day? It’s wise in my opinion to have some days off from visiting

She does indeed, well Monday to Friday and then I go on weekends. We’ve had the conversation many times about this being too much, especially as he doesn’t retain that anyone has visited, but given the unstable nature of his health she can always find a reason to go.

For example we’ve already had two doctor call outs this week for different issues so even if I get her to agree to skip a day something like that will happen and she’ll use it as an excuse to go anyway.

Apologies for being slow with updates, my head is spinning with so much going on. Seems to be a barrage of information every day with the same people often contradicting what they have said before.

Has anyone got any experience of getting a lawyer involved and if so did they feel it was worthwhile? I’m struggling with working full time, trying to look after my mum (who has not taken this well), being ill myself (nothing serious thankfully) and trying to get my head around all this info.

The situation at the moment is I’ve lodged an appeal but they haven’t even bothered to acknowledge they have received it while the date the funding ends rapidly approaches. In fact they haven’t even bothered despite two requests to actually state what the appeals process is.

Which leads onto my next point. I’ve got a copy of the Dept of Health’s National Framework for NHS Continuing Healthcare and none of the processes in it seem to have been followed.

The process we had was:
informed at the last minute of a review of my dads care which took place back in June
a letter sent to the home last week saying funding would stop on 21st Sept

The process outlined in the documents is:
a review which concentrates on care requirements and is not expected to be a reassessment of eligibility

These reviews should primarily focus on whether the care plan or arrangements remain appropriate to meet the individual’s needs. It is expected that in the majority of cases there will be no need to reassess for eligibility.

If there is then a question around funding a full reassessment of eligibility should be carried out and funding should remain in place

It is a core principle that neither an ICB nor a local authority should unilaterally withdraw from an existing funding arrangement without a joint reassessment of the individual, and without first consulting one another and the individual about the proposed change of arrangement. Therefore, if there is a change in eligibility, it is essential that alternative funding arrangements are agreed and put into effect before any withdrawal of existing funding, in order to ensure continuity of care. Any proposed change should be put in writing to the individual by the organisation that is proposing to make such a change. If agreement between the local authority and the NHS cannot be reached on the proposed change, the local disputes procedure should be invoked, and current funding and care management responsibilities should remain in place until the dispute has been resolved.

it then goes on to state that if a decision to withdraw funding is made meetings should take place if it is disputed and nothing should be changed until a plan of action and alternative funding is agreed.

And to top it all off this should all be done within 28 days.

Surely when they haven’t remotely followed their own process they can’t just stop funding.


They can’t - but it doesn’t mean they won’t. Forward copies of all your emails to the most senior person you can find at the relevant ICB. Tell them you require acknowledgement of receipt within 24 hours, and an explanation why you have had no response. I suggest you should add that failure to contact will result in a complaint to NHS England.


thanks, I’ve read it so many times and to me it just reads they have to keep funding while its in dispute, plus 101 other things they haven’t done correctly up to this point. But I’ve got the care home manager and my Dads social worker saying that’s wrong and we need to pay.

I’m thinking of throwing the word negligence in there because reading how it should work the focus of reviews should be on the standard of care and any additional care needs, not a chance to withdraw funding. I therefore think it can be argued his care needs are being neglected as that is an afterthought to them saving money

My understanding is the same as yours, and if the regulations state it (they certainly used to) then no one can make you pay. I can understand the care home giving dodgy advice, but the social worker would be out of line


I forgot to add that you have a right to a copy of the paperwork used at the meeting (the Decision Support Tool) and the recommendations from it: and the previous one. That way you can compare the findings. The hard part is challenging. The support tool and the framework are not legally binding. They’re full of “permissives” rather than absolutes: “Should” instead of “must” – and a fairly recent court case threw out a challenge on that basis. If you look up “continuing healthcare legal challenge” you can find case histories and solicitors willing to take on cases – some are no win, no fee. If you go down that road, immediately ignore everything else I’ve told you and follow the advice of your solicitor.


Hi Dave.

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