Continuing Healthcare DST Assessment

Hi All

Late in 2019 my elder brother informed me my mother’s NHS funding had been stopped. My mother had been Fast Track CHC funding due to discharge from hospital with a poor prognosis. I couldn’t understand why her funding had been stopped because, although she had good days, she only deteriorated further.

So I asked my elder brother to send me the paperwork that he couldn’t understand. My first opinion after reading such was my mother would be no longer needing her Zimmer frame, but would be using a skate board to move around the care home she was in. I have exaggerated here, but I think those who have been through this process will understand why.

I appealed on my mother’s behalf. And from this moment it would seem barriers were put in my way. I discovered the person my elder brother said was mum’s social worker wasn’t registered with Social Work England. When I telephoned the switch board the operator said “I’ll just put you through to the socail worker…” or words to this effect. On speaking with the “social worker” I asked point blank whether she was a social worker. After being a bit lost for words I was informed she was a ‘Case Worker’.

To find out what a case worker does I searched online for case worker jobs by the relevant Local Authority and, woe and behold, it would seem finance had a significant bearing on the role…

I complained to the Local Authority regarding a member of staff calling a person a social worker who was not a social worker, but was fobbed off with the switchboard operator not knowing all. My experience of switchboards is that a name, job title, department and extension number are all on the screen.

After the CCG providing the impression I could not appeal a Decision Support Tool without a Power of Attorney and, due to the time a POA takes to register, would have exceeded the 6 month time limit to appeal, I was going through extreme mental turmoil. But I sent emails to my mother’s MP, the CEO of the CCG and many others… it would seem I had overcome the first big obstacle - I was being provided additional time.

On subsequently reading the NHS Constitution, it would appear anybody can appeal a healthcare matter…

The CCG wanted to review the DST, but I pressed for a new DST due to my mother’s continued decline.

I attended a new DST completion with my elder brother as representative’s of my mother. I had provided prior notice of wishing to record the meeting as a form of personal note taking. I was told that I would be told of any objection to such. After travelling over 300 miles to the meeting, the local authority’s social worker objected to the recording unless I provided a legal document as to the purpose of the recording. I felt “high jacked” at the last minute because I am not legally qualified to write legal documents.

I’d like Albany reader of this to bear in mind NHS professionals cannot object to healthcare recordings as a form of personal note taking… I would suggest, after contacting the data protection ombudsman’s office, nor can the social worker in performing a public service. Also, health and social care professionals cannot hide behind data protection laws + they are acceptable for their actions.

Was a recording to have been made as a form of personal note taking, the social workers recollection of the meeting could have been substantiated as incorrect.


How could my elder brother (whose reading and writing skills are not beyond that of a primary school leaver today) and myself with just one GCSE English O-level challenge a senior nurse assessor, a CCG’s QIPP and a Social Worker and hope to succeed in representing our mother? We done so to the best of our ability, but after over 3 hours it was their opinion that my mother did not have a primary health care need.

After many, many months of doing everything,but getting nowhere, I had a free discussion with a uk advocacy company. I was asked to send the paperwork I had accumulated and the reasons why I felt my mother had her care needs misrepresented. The advocate got back to me and it would seem I had provided sufficient grounds for the advocate to contact the Clinical Commissioning Group on my behalf.

The Advocate’s emails were being responded to beyond “we acknowledge receipt and will put on file”.
It would seem now the CCG were dealing with a professional rather than somebody from a South London council estate the “process” seemingly designed to make those challenging CCG CHC decisions to throw in the towel, progress through the process was being made.

After a Local Review Meeting my mother was found to have a primary health care need - not to the whole period being challenged at the LRM, but a substantial part of such.

Unfortunately, Covid happened and my mother has died. Her home was sold to pay outstanding care home cost…

I have read that some consider the local authority’s social worker’s “rubber stamp” Decision Support Tools. My own opinion would be the same - it is the social worker’s responsibility to ensure their employer is not providing services beyond what the local authority is legally able to provide. It would also seem many lose sight of the Local Authority in the battle to right a wrong with the CCG. It would seem the rubber stamping of DST’s is done with impunity and contributed to a flawed decision.

I have been reading a letter from my mother’s local authority stating her disability benefits will be stopped. These benefits were stopped in the period my mother has finally be found to have a primary health care need. When a local authority provides services they are not legally able to provide, they are acting Ultra Vires. Outside of what they have the power to do.

Now, to ensure the local authority doesn’t slip away Scott free I have been pointed in the direction of English Common Law and Restitution - a person being put back into the same position they would have been in had the flawed primary health care decision not been made in the first place. The local authority has contributed to what could be many thousands of your loved one’s benefits having been stopped.

Don’t give up! Don’t let the Clinical Commissioning Groups or Local Authorities get away to what, in my opinion, could be considered defrauding elderly and vulnerable persons out of most of their life’s savings.

I would wish to thank CASCAID and Health Advocacy UK for, even though I’d probably gone over the mental edge on occasions during the continuing health care appeals process, pulling/putting me back on track.

I would NEVER want to go through this process again - being put through a meat grinder is the only way I can explain such.

The moral of the story is to seek the assistance of a professional advocate before you even attend a Decision Support Tool completion.

PS You may find those responsible for the assessments all have the fore knowledge to put their loved one’s assets into trust at the first sign of dementia… Maybe you should too?

Thanks for sharing your story, Richard.