Case studies & success stories
Parkinson’s CHC Appeal Story
We helped with
CHC Appeal
Farley Dwek Solicitors have recently concluded an appeal case for the family of Mrs X, a lady with advanced Parkinson’s disease, who was admitted to hospital in April 2021 due to myocardial infarction, UTI and sepsis. Whilst in hospital she developed a large and deep necrotic area (grade 4 pressure sore) to her sacrum.
On discharge from hospital, the Tissue Viability Nurses advised that she needed two hourly repositioning, due to her severe pressure sore, which could not be provided in the community and consequently. Mrs X was admitted to a Nursing Home in May 2021.
She was assessed by DST in June 2021, but despite the non-healing Grade 4 pressure wound, as well as multiple other health needs, she was found ineligible for CHC funding.
Mrs X continued to deteriorate and in mid-December 2021, she moved from the Nursing Home to the home of her son and daughter-in-law for end of life care. She was immediately awarded Fast Track funding and sadly passed away two weeks later.
The eligibility decision from June 2021 was appealed to the NHS Integrated Care Board (ICB) and a Local Resolution Meeting was scheduled for July 2022. Based on our Submission and verbal representations, the ICB increased several levels of need in the individual care domains, but failed to revise the Key Characteristics to reflect those increases, meaning that Mrs X’s holistic care needs had once again not been robustly considered.
The ICB upheld their original decision of ineligibility and a request for Independent Review Panel was subsequently lodged with NHS England.
Our CHC team prepared an extensive Appeal Submission for the Independent Review Panel which took place earlier this year, attended by one of our specialist advocate representatives. The IRP concluded that the ICB’s decision was clinically unsound and recommended that Mrs X WAS eligible for CHC funding at the time of the DST in June 2021.
The ICB have subsequently accepted the IRP’s recommendation and have agreed to reimburse fees up to the date of the Fast Track award in December 2021.