Where are we since the Coughlan Judgment and the introduction of the National Framework?

No longer should you need to sell your house to pay for your care or give up work to be a carer for a relative, spouse or friend as a result of incompetent or flawed NHS Continuing Healthcare assessments. The principles behind this statement are sound, so why aren’t they being applied? Why are so many thousands of people still being compelled to sell their home to pay for their care needs? How has society come to this malaise and what can be done to rectify the problem?

Where the problem started: The background

In 2002, regional health authorities were renamed and merged to form 28 Strategic Health Authorities (SHAs). Each SHA had its own governance and responsibility for running and commissioning local NHS services. With its own autonomy, too, each SHA had its own assessment criteria and interpretation of what healthcare needs qualified for Continuing Care i.e. the long-term NHS funding of elderly and disabled patients (usually living in care homes with nursing). Continuing care funding meant that an individual’s social and healthcare needs were paid for in full by the NHS, free of charge and without any form of means-testing – to meet the overriding principle of ‘free care at the point of need’.

Unfortunately, this autonomy delegated to SHAs, produced a disparate range of inconsistent outcomes across the country, which became dubbed the ‘postcode lottery’. Success or failure was entirely in the hands of your local SHA and how they chose to apply their own assessment methods and criteria. As a result, therefore, your chance of securing free NHS funded care largely increased or decreased simply by virtue of where you lived.

There was a general misunderstanding as to what criteria qualified as healthcare needs and what should be funded free of charge by the NHS (i.e. free at the point of need), and what needs fell into social care needs, which were to be funded by the local authority and be subject to means-testing (ie you might have to contribute to the cost of your care needs).

What happened to change all this?

The Court of Appeal decision in the Pamela Coughlan case [1999], was the foremost landmark decision that started the path of change. It was the precursor that eventually led to the creation of a nationwide, consistent approach when applying assessment criteria for Continuing Care.

In short, the Coughlan judgment established that where a person’s primary need is for healthcare, the NHS is responsible for the full cost of the placement and care package (i.e. healthcare and social care needs and accommodation). Only if the individual’s need is not primarily for health care – i.e. not the responsibility of the NHS – may consideration be given to whether local authority social services could purchase nursing care in very limited circumstances (and pass the cost to the individual) whose healthcare needs are:

(i)  merely incidental or ancillary to the provision of the accommodation which a local authority is under a duty to provide; and

(ii)  of a nature which it can be expected that an authority whose primary responsibility is to provide social services can be expected to provide.

So, the Coughlan case was fundamentally instrumental in clarifying the legal distinction between healthcare and social care needs and providing a clear boundary line as to which body has responsibility for providing (and paying!) for the individual’s care.

What’s happened since Coughlan?

Following the Coughlan court decision, SHAs and Local Authorities were mandated to consider eligibility for Continuing Care, by first applying the ‘primary healthcare needs’ test before any financial assessment and consideration should be given to means-tested local authority funding.

But how easy was it for Strategic Health Authorities to follow Coughlan?

In 1999, following the Coughlan case, the Department of Health issued guidance which asked health and local authorities to satisfy themselves that their continuing care policies were in line with the Coughlan Judgment. However, confusion and incorrect circular guidance that followed, only contributed to the blurring of boundaries between healthcare and social care needs.

Whilst trying to co-operate, some SHAs still failed to ensure that their eligibility criteria and assessment methods were operated in a Coughlan compliant and compatible manner. Some SHAs wrongly thought that Continuing Care was only available if the individual was at end of life or receiving palliative care.

The confusion continued to result in many vulnerable people with chronic, but stable healthcare needs, mistakenly being passed over to their local authority (and means-tested assessments) and their families still being forced to pay for healthcare (typically from the sale of their home), which should have been the NHS’s responsibility to fund free of charge.

Despite the Coughlan Judgment, there was still widespread inequality and injustice. Something had to be done to rectify the situation and reimburse those individuals who had been the victim flawed and inconsistent assessments. Many thousands had wrongly been forced to pay for their care that should have been provided free by the NHS.

The emergence of national assessment criteria

However, in February 2005 Ann Abraham, Health Service Ombudsman, reported to the Select Committee on Health* that there were still significant delays in carrying out retrospective reviews; difficulties of interpretation of the eligibility criteria; systemic flaws in the way retrospective reviews were being carried out; and delays in making restitution payments to those found eligible for Continuing Care funding. Although it was recognised that there had been improvements, standards still fell short of the mark and healthcare professionals needed more guidance, training and support in this difficult area.

She said, “In more than half of the cases my Office examined we found that the assessments had not been carried out properly. The problems included poor quality clinical input to both assessment and decision making, inadequate documentation, failure to consider changes in a patient’s health care needs over time, and lack of involvement of, and poor communication with, patients, carers and relatives.”

Sadly, these issues still resonate as much today as they did over 15 years ago when the Abrahams report was made. So, has anything changed?

The Birth of the National Framework for NHS Continuing Healthcare Funding (‘National Framework’)

There was a growing demand to rectify the financial hardship and injustice caused to families by an evident failure to understand what Coughlan was all about and impose adherence to, and application of, the Coughlan case.

There was a distinct need to create a clear, transparent, comprehensive and comprehensible, user-friendly, national reference tool to ensure fairer and consistent assessments for eligibility and robust decision-making; a national tool:

  • Which could stand up to scrutiny and eradicate the postcode lottery and differential treatment of individuals across the county;
  • That incorporates a standard set of agreed competencies for those carrying out the assessments, with proper training and a uniform approach to fairly compensate those who had suffered injustice and wrongly been denied NHS funding where the eligibility criteria, or the way they were applied, were not clearly appropriate or fair;
  • That would remove delay and move to a quicker decision-making process and eradicate unsafe decisions and abuse or process;
  • Give practical guidance that could be understood and applied in easy practical steps by healthcare professionals, patients and carers alike.

And so, the National Framework for NHS Continuing Healthcare was born, and with it followed the abolition of Strategic Health Authorities on 31st March 2013. Thereafter, responsibility for compliance with National Framework rested with local Clinical Commissioning Groups (formerly Primary Care Trusts).

Benefits of the National Framework for NHS Continuing Healthcare:

The National Framework is a single national set of eligibility criteria that came into effect in 2007, known as the ‘National Framework for NHS Continuing Healthcare’ – so that individuals whose primary need is a health need, could receive fully funded NHS care no matter where or in what setting they live (e.g. whether in their own home or a care facility or hospice etc).

The National Framework incorporates, integrates and amalgamates the current best practice, guidance, protocols, process and assessment tools; issues best practice and clearer guidelines to make the eligibility assessment process easier to understand and to operate; and introduces a consistent approach and response to improve the public’s understanding of eligibility, and of the assessment process.

The National Framework for NHS Continuing Care and NHS-funded Nursing Care 2018

Since its introduction in 2007, there have been further updates to the National Framework in 2009 (renamed: The National Framework for NHS Continuing Healthcare and NHS-Funded Nursing Care) and again in 2012, and more recently in October 2018. Each version has sought to make improvements to the assessment process and compliance with the underlying Coughlan principles.

The latest version of the National Framework does provide greater clarity for NHS assessors, professionals and individuals involved in the assessment and appeal process. For example, the 2018 edition of the National Framework specifically incorporates the Care Act 2014 and reliance on the Coughlan Judgment. It reconfirms the boundary lines on the care that a local authority can lawfully provide and what care is the responsibility of the NHS. It also reinforces the duty on the health and social care authorities to carry out proper assessments for NHS Continuing Healthcare first, before there is any mention of how the care will be funded.

However, at Farley Dwek, as legal practitioners fighting for justice for our clients, the National Framework is still deficient in many areas and much more still needs to be done to perfect the model. There is still inconsistency in interpretation and approach, and sadly the postcode lottery is as much alive today as it was back in the 1990s. Individuals are still being denied Continuing Healthcare funding through flawed or incorrect NHS assessments and being subjected to inordinate delays in processing retrospective appeals (now exacerbated by COVID). Some delays can result in claimants passing away before the matter is resolved and restitution repaid. Homes and assets are still being sold, and hard-earned life-savings are being eroded just to pay for care, which should have been paid for in full, free of charge by the NHS, had a fair and sound assessment been carried out in the first place (indeed, if one took place at all!).

Whilst the 2018 National Framework is certainly a vast improvement on the pre-Coughlan era, unfortunately, post-Coughlan, and since its introduction, the Framework has been criticised for perpetuating confusion and inconsistency. There is a need to create a fair and robust system that works for practitioners, and yet gives families confidence that their relative’s case has been assessed fairly, properly, and expeditiously.

To achieve greater consistency and reduce the financial misery and stress caused to families by incorrect decisions where funding has been wrongly rejected or withdrawn, there needs to be more training of NHS assessors, greater transparency when applying the National Framework, less room for subjective interpretation of the rules and guidance, and the perceived scandal of financial gatekeeping. Admiral Philip Mathias has publicly called the misery foisted by the NHS on individuals who have been let down by the system and flawed assessments as, “probably the biggest financial scandal in the history of the NHS.” The winds of further reform are brewing…

Read our recent blog Admiral Philip Mathias blog:
Admiral Mathias Continues His Fight For Justice For Families Who Missed Out On NHS Continuing Healthcare Funding

We hope that the next revision of the National Framework addresses these concerns and more.

For further background reading as to historical issues and the evolution of the National Framework, read:

Memorandum by The Law Society (CC 35)

https://publications.parliament.uk/pa/cm200405/cmselect/cmhealth/399/5031738.htm

*Memorandum by the Health Service Ombudsman for England (CC 23)

https://publications.parliament.uk/pa/cm200405/cmselect/cmhealth/399/5031702.htm

Memorandum by the Department of Health (CC 9)

https://publications.parliament.uk/pa/cm200405/cmselect/cmhealth/399/5031708.htm

Farley Dwek Solicitors work with a team of specialist nurses who have all spent many years working within the NHS, specialising in Continuing Healthcare Assessments. Together, we can offer you expert advice and professional advocacy support. You don’t need to fight this battle for NHS funding alone. Visit our website for more information as to the wide range of expert services we offer you at every stage of your assessment or appeal.

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Admiral Mathias Continues His Fight For Justice For Families Who Missed Out On NHS Continuing Healthcare Funding

 

NHS Continuing Healthcare Funding (or ‘CHC’ for short) is a package of care that is funded by the NHS for those individuals who have a ‘primary health need’ – ie whose care needs are over and above what the Local Authority can lawfully provide.

This principle was established in the landmark Court of Appeal case in Pamela Coughlan v North and East Devon Health Authority (1999) and the rationale has since been incorporated into the Care Act 2014 and is included in the National Framework for NHS Continuing Healthcare Funding (revised 01.10.2018).

The National Framework is the definitive guidance which NHS practitioners should adhere to when assessing individuals for their eligibility for CHC – free funded care.

The National Framework states these core principles, summarised below:

  • CHC is available if you are over 18 to meet needs that have arisen as a result of a disability, accident or illness.
  • CHC is not dependent on having a particular illness, diagnosis, condition or disease.
  • The individual should be at the heart of the assessment process (‘person centric’)
  • CHC is ‘free at the point of delivery’ – ie free of charge when you need it.
  • CHC is paid irrespective of the care setting where the care takes place. So, it is irrelevant whether the care is provided at your home, a care or nursing home, hospice or any other care facility.
  • CHC should never take into account your wealth and private means of funding your care. Wealth is never a consideration.
  • CHC includes your social care needs and the cost of accommodation.
  • CHC Funding is not discretionary but a legal statutory duty if the eligibility criteria are met.
  • If you have CHC, you should not be asked to pay any ‘top-up’ fees towards the cost of your accommodation for assessed healthcare needs.

This all sounds quite straightforward so far. You pay tax and at the point you need free care from the NHS for your long-term healthcare needs, you should get it, right? Not quite. Read on…

CHC is for individuals who have intense, complex or unpredictable healthcare needs that are above and beyond what a Local Authority can legally provide. There is a fine dividing line as to which care needs fall on the NHS side, and which fall into the remit of the Local Authority. That is the cause of much debate as the outcome determines who pays for your care. In short:

  • CHC paid for by the NHS is free of charge
  • Local Authority funded care is means-tested, which means that you may have to contribute towards the cost of some or all of your care, much depending on whether you have capital, assets (usually a home) or savings worth in excess of £23,250.

The problem with the National Framework, is that its guidance is open to interpretation and that can lead to it being applied by practitioners subjectively. Subjectivity, in this arena leads to inconsistency in its application, disparity in decision outcomes, and the potential for misinterpretation, abuse of process or ‘rule bending’ to suit the cause.

That said, most individuals embarking on seeking CHC for their relative, or who are already entrenched in the assessment or appeal process, will generally struggle to get to grips with 167 pages of National Framework text that has little to help them by way of practical examples of what to do or how to go about the funding process.

Despite the catch phrase in the National Framework that the CHC assessment process is intended to be ‘person centric’, it is really designed with NHS practitioners in mind. They will get training and instruction in its use and application. The average family will therefore be at a significant disadvantage, and from experience, are likely to be overwhelmed when applying for CHC or challenging the NHS in respect of any abuse of process or flawed outcome. Studying the National Framework is one thing; arguing for your relative’s entitlement to CHC, face-to-face with trained NHS assessors, is another!

Families often tell us how they found the process intimidating and some felt the NHS assessors came with a pre-determined outcome and didn’t want to listen. The National Framework does not prepare individuals how to go about the CHC process, nor how to best present their relative’s case or appeal.

The other area of concern is that the inconsistency in applying the National Framework has always caused a nationwide variance as to which areas of the country are more likely to award CHC. This is often referred to as the ‘postcode lottery’. See our CHC Funding Map for more information.

The result is that many thousands of people who might be entitled to CHC are missing out and are paying for their care unnecessarily – often having to sell their homes or use life-time savings, instead of having their healthcare needs paid for in full by the NHS, free of charge. This has been described in the press as a ‘national scandal’ and sometimes referred to as the ‘NHS’s best kept secret’. For additional reading, see the National Survey results that we commissioned which have provided some startling statistics!

Victoria Derbyshire raised public awareness of this financial scandal when she launched a full investigation into the depth and scale of the matter in her excellent BBC documentary in June last year (2019). Her programme featured one of our directors, Andrew Farley, and also retired Rear Admiral Mathias. Admiral Mathias, former nuclear submarine commander and Director of Nuclear Policy at the Ministry of Defence, told the story his personal lengthy fight spanning several years to get CHC for his late mother. He mentions the hurdles he had to overcome to win his case and successfully recover £200,000, retrospectively, in wrongly paid care fees that should never have been paid had his mother been correctly assessed for CHC.

Admiral Mathias, has previously been quoted in the Daily Telegraph as saying: “In terms of complexity, the mental capacity required and the analysis skills needed, applying for CHC funding was as complex as some of the nuclear deterrent policy I worked on.”

You can read more in our blog: Andrew Farley, Solicitor, on the BBC Victoria Derbyshire Show

Admiral Mathias featured again in the national press only recently at the top of page 2 in the Daily Telegraph (01/10/20). In case you missed it, we have copied some salient paragraphs from Henry Bodkin’s article below:

“Former head of Britain’s nuclear deterrent to sue Matt Hancock over £5bn care ‘scandal’

Joy Mathias before her illness, with son Rear Admiral Philip Mathias who is campaigning against inequalities in CHC funding.

The former head of Britain’s nuclear deterrent is suing Matt Hancock to force the NHS to pay for elderly patients’ long-term health costs.

If successful, the threatened judicial review by Rear Admiral Philip Mathias could cost the health service £5 billion in paid back medical fees.

The case concerns the failure by local NHS bosses to pay for the continuing healthcare (CHC) of tens of thousands of eligible patients a year.

It follows an investigation by The Telegraph which found that officials’ refusal to fund the costs was forcing patients to languish in hospital, or to pay sometimes hundreds of thousands out of their own pockets to manage conditions such as Parkinson’s and dementia.

Under national CHC rules, any patient with a significant health problem should have their care and nursing fees paid in full by the NHS, provided their condition is the main reason they need help.

This is distinct from means-tested adult social care, which is funded by local councils.

However, analysis reveals an up to 20-fold variation in the chances of securing CHC funding between different NHS clinical commissioning groups.

Meanwhile NHS “snapshot” data shows that, nationally, the number of people eligible for long-term funding has actually gone down, despite an ageing population suggesting that the demand should be higher.

Patient charities have complained of a labyrinthine and attritional application process that forces patients to give up or wrongly persuades them they are not eligible.

Rear Admiral Mathias, former director of nuclear policy at the Ministry of Defence, believes up to 10,000 people are unlawfully denied CHC each year.

He was forced to fight a two-year battle involving more than 100 letters with Wiltshire CCG to recover £200,000 paid by his 90-year-old father to fund his mother, Joy’s, nursing home fees, which the organisation should have funded.

With the help of Ian Wise QC, he has now launched legal proceedings with the “strategic intent” of changing NHS behaviour across the country.

“In terms of the sheer scale of this scandal, measured by the significant number of old, ill and vulnerable people adversely affected and the huge level of unlawful financial deprivation, this is very possibly one of the biggest government scandals of modern times.”

Rear Admiral Mathias said that on the basis that the 50,000 people allegedly unlawfully denied CHC over the past five years had, on average, had to pay £100,000 – a “reasonable assumption”, he said – then the NHS could be liable for £5 billion, if the judicial review is successful.

He said a win in court could be the most significant judgment since that concerning payment protection insurance (PPI).

He added: “The Department of Health and Social Care and NHS have grossly violated the human rights of some of the most vulnerable people in society, discrimination based on age and disability, with many being unlawfully forced to sell their homes when their care should be funded by the NHS.”

The former submariner is launching a Crowd Justice appeal on Thursday to raise the £30,000 needed to fund the first stage of the judicial review.

A key plank of his case will be to challenge the secretary of state to explain the significant variations chances of receiving long-term health funding across the country.

Official figures show that since then, average eligibility per 50,000 population has fallen – from 68.77 per 50,000 in 2015/16 to 57.70 in 2018/19.

2019 figures also showed that show the number of people who were found to be eligible for CHC ranged from just 11.9 per 50,000 people in Luton, Bedfordshire, to 230.3 per 50,000 people in Salford, in Greater Manchester.

A Parliamentary briefing paper sets out NHS England’s efficiency plans, which require clinical commissioning groups (CCGs) “to make £855 million of savings on CHC and NHS-funded nursing care by 2020- 21”.

Need expert help?

You don’t have to be a lone soldier like Admiral Mathias and fight your CHC battles alone.

Farley Dwek Solicitors provide a wide range of legal services that cover every aspect of CHC, start to finish. We have many years of expertise supporting families to fight for their entitlement to get the free funded care their relative deserves. Whether your relative is about to go into a care home, is already in a care home or is seeking to retrospectively recover care home fees that were wrongly paid, we can help.

We offer nationwide coverage and coupled with our team of expert CHC nurses, we provide a unique blend of both professional legal and clinical expertise, advice and advocacy services – so that you don’t have to fight your battle for CHC alone.

Get in touch if you need help and email your enquiry to us at: enquiries@farleydwek.com.

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Coronavirus: 1st September 2020 Sees CCGs Gear Up To Reintroduce Assessments & Appeals

CCG assessments & appeals due to restart from 1st September 2020.

Following recent Government guidance, Clinical Commissioning Groups (CCGs) have been preparing to restart their assessment and appeals to determine eligibility for NHS Continuing Healthcare Funding (CHC) with effect from 1st September 2020.

CHC is a free package of care funded by the NHS which pays for an individual’s healthcare needs, including their social care needs and accommodation. CHC is free at the ‘point of delivery’ i.e. when you need it, and is paid irrespective of your financial means or the setting where the care is provided – be it in your own home, a care or nursing home, hospice or other care facility. So, essentially, if you have a ‘primary health need’ – meaning that the main reason for care is due to health reasons rather than social care needs – all your assessed healthcare needs should be paid in full by the NHS and you should not be asked to contribute.

Furthermore, as CHC includes the cost of your accommodation, it is unlawful for care homes to charge ‘top-up fees’ for your relative’s assessed healthcare needs. Challenge your care home if they seek to charge your relative for the shortfall in the cost of CHC care being funded by the CCG and the higher cost of care of keeping them as a resident in that home.

Prior to 19th March 2020

Assessments and appeals for CHC Funding and appeals against CCG decisions to refuse or withdraw funding, were progressing on a relatively even keel. Some CCGs were notably more proficient and on top of their game than others, but by and large, the CHC process was moving forward again after many years of infuriating and exasperating delays.

These delays were caused primarily as a result of an explosion of new claims that flooded into the CHC system when the Department of Health imposed a deadline to register retrospective reclaims (for wrongly paid care fees dating back to 01/04/2004 – 31/03/2011) by 30th September 2012. A second deadline was then introduced shortly afterwards to register any retrospective claim for funding between 01/04/2011 to 31/03/12, by 31st March 2013.

In practical terms, CCGs were swamped with thousands of new claims, many of which were potentially spurious, unmeritorious or delusional, as people scrambled to register their claim at short notice just to protect their position. Many claims management companies who saw this as the next ‘PPI’ jumped on the bandwagon, too, despite not having the faintest clue about CHC or the eligibility process! So, from having around 2000 claims in the pipeline for CHC Funding, CCGs became inundated with an estimated 60,000 new claims, nationally, which clogged the system for years and led to inordinate and frustrating delays. Under-resourced CCGs just couldn’t cope with the volume of claims generated by their own deadlines.

The result: It has taken years for CCGs to get on top of their backlogs, and we at Farley Dwek, know only too well the problems they have faced – as many of our clients have been on the receiving end of these delays. We have seen countless cases where CCGs have wrongly rejected or refused CHC Funding, only for it to be awarded (or reinstated) on appeal years later. Thankfully, we have seen a noticeable upturn in the last 18 months. Many historic cases, perhaps some as old as 5 – 7 years, are now reaching finality – having been forced by flawed CCG decisions to appeal all the way down the line to NHS England, and when necessary, to the Parliamentary and Health Service Ombudsman, to bring pressure on CCGs to reopen cases and conduct robust reassessments.

Our clients have enjoyed much success as a result of our intervention and relentless perseverance over many years, fighting for their entitlement to CHC Funding. However, many have found the whole CHC process stressful, daunting and infuriating, and the added delays over many years have often taken their toll on families whilst battling to secure funding for their relative.

After 19th March 2020

When COVID-19 became more prevalent, virtually all assessments and appeals were put on hold, postponed or deferred. Families who had been waiting for an assessment of their relative’s eligibility for CHC Funding, or were waiting for an appeal hearing, feared their cases would be pushed into the long grass and never see light of day again – reminiscent of the immediate position post 31st March 2013 deadline. In the meantime, families could be obligated to run down savings and investments or sell assets to pay for their relative’s care, whilst awaiting a decision.

However, the coronavirus pandemic forced the Government into action. From 19th March to 31st August 2020, it provided emergency COVID discharge support funding – designed to help hospitals speed up discharging patients where clinically safe to do so in order to free up beds, whilst providing the patient with funding to assist their recovery, rehabilitation and reablement. This emergency funding will continue for those already in receipt of it during this period, until such time as they are formally assessed for CHC Funding.

In the meantime, your relative should not be asked to pay for their care if this funding is in place.

The emergency COVID funding ceased on 31st August for any new hospital discharge cases beyond this date.

The latest position-1st September 2020

Instead, with effect from 1st September 2020, anybody leaving hospital and requiring new care and support will be automatically funded for 6 weeks. During this period the NHS should carry out an assessment of their longer-term healthcare needs and also communicate their decision within this same 6-week timeframe.

In default, the NHS (and/or Local Authority) may be obligated to continue paying for care after this time. So, it is in their best interests to get these assessments underway expeditiously if they want to protect their budgets. However, whilst waiting for an assessment, your relative should not be asked to pay for their care.

If, prior to being discharged from hospital, your relative was already in receipt of an existing care package of funded care, whether provided by the NHS or Local Authority, that funding will continue and be paid for by the same organisation.

Similarly, if your relative was self-funding and paying for their care out of private means, that position will remain the same, too, until an assessment for CHC Funding takes place.

If, upon assessment, your relative is found eligible for CHC Funding, any care fees paid whilst waiting for an assessment, will be reimbursed to them.

Although this is a great initiative by the Government, it does beg the question as to how CCGs will cope with all these new assessments which have to be completed within 6 weeks following discharge from hospital, plus integrate all the thousands of postponed assessments and appeals that were pending pre 19th March 2020 and deferred due to COVID, but also at the same time incorporate the many hundreds of new assessments filtering into the CHC system daily. This will be a mammoth logistical challenge for all CCGs, who will need to recruit and train additional staff to complement their existing CCG teams, whilst simultaneously integrating CHC staff returning from redeployment at hospitals. The less well-organised and under-resourced CCGs may flounder badly under the new reintroduction guidance, and worryingly, this could see a return to the post 31st March 2013 position once again.

Regardless of the efficiency measures introduced, there will inevitably be huge backlogs and delays created as CCGs practise ‘damage’ limitation and juggle their budgets. Some unknowns:

  • Will CCGs use this opportunity to become more streamlined in their approach and move assessments and appeals through the system more proficiently, or will it be more of the same, or possibly worse?
  • Will we revert to the post 31st March 2013 deadline position with retrospective appeals taking years to reach a final outcome decision?
  • Will infuriating delays cause families to give up in frustration, or will it embolden their resolve once again to fight on and press for their right to CHC Funding, however long it takes?
  • Will delays and inefficiency cause some CCGs to incur lots of wasted interest on retrospective restitution payouts which will eat into their budgets at the tax-payer’s expense?

Make no mistake, CCGs have a huge task ahead of them if they are going to be able to manage the whole CHC assessment and appeal process robustly and steer a steady ship and keep CHC Funding moving forward on an even keel. It is too early to tell yet, and we shall all have to wait and see…

If you need professional expert help with your relative’s assessment, review or appeal, do get in touch. Send your enquiry to: enquiries@farleydwek.com

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