Case studies & success stories
Successful CHC Appeal Story
We helped with
CHC Appeal
This week’s success story concerns a patient who was in receipt of CHC funding for over a decade, only to have this withdrawn as they approached the end of their life.
The patient’s care had been funded by the NHS for many years, owing to their complex behavioural and psychological needs. As their health deteriorated, their physical needs began to predominate, leading to a decision by the NHS to reassess their eligibility for CHC funding, concluding they no longer met the criteria.
The review which recommended reassessment, was done over the telephone, as was the subsequent full assessment. None of the Assessors had ever met the patient or reviewed a sufficient quantity of evidence to glean an accurate picture of their needs. This resulted in funding being withdrawn at a time when the patient’s needs were unstable and increasing, only months before their death.
Farley Dwek were instructed to appeal the decision to withdraw funding and prepared full Written Submissions, clearly demonstrating the patient’s needs had changed but not reduced. Following Local Resolution, the NHS accepted it had made the wrong decisions and all fees incurred by the patient were reimbursed.
Remember: To justify a full reassessment of eligibility and sanction withdrawal of an existing package of CHC funding, the NHS must demonstrate that needs have been permanently reduced or eliminated. A change in need does not necessarily equate to a reduction in need.