New deadlines for retrospective claims for NHS Continuing Healthcare
Get your care fees claim in quickly
The Department of Health has issued new deadlines for people in England wanting to claim back care home fees they believe were wrongly charged.
These new deadlines seem designed purely to make life easier for the new Clinical Commissioning Groups (part of the NHS reforms) – but certainly not to help elderly people or their families access the funding they’re entitled to in law.
If your elderly relative was paying care fees for full-time care between 2004 and 2011, the new deadline for retrospective claims for NHS Continuing Healthcare funding is now 30th September 2012.
In more detail…
If your relative was receiving full-time care (at home or in a care home) and they needed care primarily for health reasons, they should have been assessed for NHS Continuing Healthcare. This is NHS funding and it covers 100% of the costs of being in a care home or receiving full-time care at home.
You can claim retrospectively for a refund of those care fees if you believe they were wrongly charged. This applies whether or not your relative is still alive.
- For periods of care between 1st April 2004 and 31st March 2011, the deadline for claims is now 30th September 2012.
- For periods of care between 1st April 2011 and 31st March 2012, the deadline for claims is 31st March 2013.
Read more about NHS Continuing Care.
Read why we believe these new deadlines are illegal.
New review timescales for Continuing Care applications after 1st April 2012.
Does anyone know if there are deadlines for the NHS to respond to applications already submitted for a full assessment? Our application has been with the NHS since last September and we still have not received notification as to whether we will be granted a full assessment and no timescales as to when this will happen.
The NHS is supposed to have the whole assessment process completed within 28 days, unless they can give you very good reasons why they can’t. Keep chasing them. This may help: http://caretobedifferent.co.uk/nhs-not-responding-to-your-continuing-healthcare-correspondence/
Does anyone know what happens when you receive the draft copy and it goes to the first panel meeting. Not sure what to expect.
I am with specialist solicitors in a no win no fee retrospective claim for my deceased Fathers care. My claim is within the published timeframes and has been with the solicitors for three years. We are now half way through the fourth year. The solicitors keep me well informed and they have now been told by The Clinical Commissioning Group that my case will be be awarded a ‘Nurse Assessor’ but this will take a further year! I cannot believe this is right and how can one person assess the terrible anomalies in the assessment of my Fathers needs. We used every penny of his money from his home and his savings as his needs were too great to be handled at home by untrained people. I don’t know who to turn to to resolve this as the solicitors seem to have their hands tied to.
My husband had a checklist done 8/7 2014. He was found eligible for NHS continuing care funding one year later on 3/7/15 by the local CCG. I have now been sent a letter to the effect that the whole case has to be reviewed with full paperwork and evidence from me, before the money I have paid for care up to 3 July 2015 can be refunded. The money may or may not be refunded back to the checklist +28 days. I have had a long telephone conversation with the retro team who claim that they are obliged to do the retro review. I claim that due process has not been followed, they are making up new rules, it gets me nowhere. Please can anyone tell me what my rights are and what to do next.
Can anyone advise me on how retrospective a ‘retrospective claim’ can be?
At the time of my Mother’s illness, transfer into a Care Home and eventual death, my sister and I knew nothing of the NHS continuance of care responsibilities. Neither were we advised of those.
Her case is over a period between November 2002 – January 2004.
My mother has been deceased ten years now. I saw the retrospective claim feature in the news four years ago. I applied in time. I have had to chase. The case was moved to different offices. I heard early this year that it was going to Nurse !. They said you will hear in October. 2016. I did not. I have just got on to the last office and that was no longer in use. I was told to e mail AGCU. RetroReview@nhs.net which I have done today. I have seen my mothers Care Home notes which were a shock. As next of kin I was never informed of some injuries including a broken pubic bone !!! I have no idea if anything at all will happen now. It feels dead in the water to me. At this rate its not only my mother that will be late, but me too !
How so true. We also have been moved from pillar to post and have just been told that we will have a decision by the end of March 2017. We have contacted the media as they highlighted the case several years ago, but it seems they have moved onto other things. Is there no one out there who will take the reins and sort out this issue?
Angela and Lynne, thank you so much for sharing a thought or two with me. I had kept an original e mail from a person 3 offices ago. I sent an e last week to her saying what a scandal. She got on to my present office who then sent an e to me a couple of days ago. They said ‘We confirm your mothers case has been to panel. However due to the many thousands of cases, we can give you no time scale whatsoever. ‘ So there we are . Keep trying everybody. Regards D
What a nightmare – My Father in Law was assessed in Hospital for Continuing Healthcare – and on the assessment it was agreed that he would qualify – however this area has a weird way of progressing this – they say he has to be assessed again after he has been in the Care Home 6 weeks – unfortunately he passed away last Friday – having paid 6000 for his Care Home – 4 weeks in advance which seems to me free money. Does anyone know if we can make a retrospective claim ?
I used a template to submit an appeal against the decision of my mother’s continuing care assessment which had to be submitted to the CCG by September 2012 deadline. Because it was in respect of assessments carried out from 2008 to 2011. They acknowledged receipt and also told us we had to submit copies of our POA so that they could continue with the appeal which we did. We heard very little until recently when we were told that they have now decided they would not carry out a respective review because assessments had been done. We took this to the ombudsman who have upheld the CCGs decision. We do not feel that our appeal has been given full consideration – surely it should not have taken from September 2012 to 2017 to just brush us off like this. The ombudsmans letter refers to the fact that assessments had been carried out – this isn’t what we had appealed against. We had appealed against the decisions made. Can we do anything else?
Well…we have been turned down. After all these years, that’s the end of that. She most certainly did qualify, but guess what. The ‘home’ had destroyed all her records !! ? At that particular home she was totally unable to walk because of the broken pubic bone that I knew nothing about. Because she could walk at the previous home, which had records, that was what they went by. She went drastically downhill .At one visit she refused to respond to me and lay in bed facing the wall. Often she was spaced out and was black and blue. The staff said she was always flinging her arms at the carers to stop whatever they were doing. …. After the refusal by whoever of the retrospective element I was told I could appeal .
I said ” No fear, and wait years ? ” This has all been a farce. My mum had a nightmare death. I have to carry guilt for life.
Perhaps I have same to look forward to. Serve me right. 2017.
How long should it take my CCG to deal with and make a decision on my appeal for nursing care funding I’m now in week 43 since I sent in my appeal and have been stalled and was only asked for my Mum’s notes from the care home in November they have now had the 5 weeks and only after my email today was I contacted by the person reviewing them. I’ve also asked for the 12 week disregard that Mum should have got in 2011 although I realise I’m probably past the deadline now.