NHS Continuing Healthcare Funding Put On Hold

With the outbreak of coronavirus it is not surprising that assessments and appeals for NHS Continuing Healthcare Funding are being put on hold, and those Clinical Commissioning Groups which are still operating in this area are likely to stop shortly.

The impact is already having a dramatic effect throughout the country.

Those with family and friends currently in hospital awaiting discharge to a care facility are at risk of catching Covid–19.

Care homes awaiting the transfer of new residents will equally be anxious to ensure that they do not import the virus with them.

Most care homes need an influx of new residents to make it commercially viable to remain open.

Some care homes have already closed their doors and will not admit new residents or allow visitors to enter in case of infection.

In the event of an imminent escalation of preventative measures and an enforced lockdown, nurses, carers and auxiliary staff in care homes may also face restricted access to their patients. Just as carers employed to look after patients living at home may be forced to reduce their support, leaving the most vulnerable and needy in society isolated and at risk.

The elderly, frail and those with serious underlying medical conditions at risk with chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis, chronic heart failure, chronic kidney disease, chronic liver disease (such as hepatitis), diabetes, chronic neurological conditions such as Parkinson’s disease, motor neurone disease, multiple sclerosis or cerebral palsy, or generally have a weakened immune system, are all considered at highest risk.

In the majority of cases, assessments for NHS Continuing Healthcare Funding start with an initial Checklist screening tool to determine whether the individual should move forward onto a full assessment carried out by a Multi-Disciplinary Team. However, if the individual cannot even be assessed for the Checklist due to the risk of the virus spreading, then many assessments will be cancelled or deferred. The Government cannot say when it will be safe to engage in social interaction again, but the current thinking is that it is going to be many months, rather than weeks. Some commentators consider it could be another 12 to 18 months yet, whilst the vulnerable, and those who have or may be in the throes of contracting coronavirus, need to remain in isolation.

Similarly, if Multi-Disciplinary Team meetings (MDT) cannot proceed either, then individuals will not know whether they are eligible for NHS Continuing Healthcare Funding or not. In the meantime, they may be required to fund their care out of private means and use up hard-earned savings. These inevitable delays will cause severe financial hardship for families as they try to find sufficient funds to pay for their relative’s ongoing care.

In terms of Local Resolution Panel appeals following the outcome of a negative MDT meeting, or further appeal to NHS England, these too will be cancelled and adjourned, causing a dramatic financial knock-on effect for those have been forced to fund their relative’s care pending the outcome of an appeal. Who knows when the hearings will be reinstated? Those at the back of the queue could face a very lengthy wait and years of anxiety, before their appeal is heard and the outcome decided.

Most CCGs are already unable to adhere to the timeframes for conducting an MDT. Appeals to a Local Resolution Panel and NHS England have generally been taking considerably longer to get a Panel hearing date, and then there are generally inordinate delays in the outcome decision being communicated to families. Now that MDTs and appeal panels are being cancelled throughout the country, families will have to dig even deeper to find additional funds to pay for their relative’s care during the intervening period.  We do not know how care homes will manage the situation or how sympathetic they will be, given that they, too, have fixed overheads and staff wages to pay in order to keep their residents well–looked after in a safe and caring environment.

We certainly are currently living in unprecedented and challenging times.

The Government’s daily warnings clearly mean staying indoors, avoiding public and social gatherings, and staying clear social contact. The inevitable impact will mean that individuals going through the assessment or appeal process, and who may be eligible for CHC funding, will have to wait until the CCG’s ‘doors’ reopen again. The CHC assessment and appeal process as set out in the National Framework for NHS Continuing Healthcare Funding and NHS–funded Nursing Care already contains flaws and, unfortunately, this unprecedented and unforeseen crisis will only fuel the public’s anxiety. Read our recent blog: Is the National Framework Still Working Effectively?

Not only will people be refused entry into the care home to check on whether their spouse, relative or friend are getting adequate care and attention and that all their daily needs are being met, but they may be saddled with the additional worry of how they are going to continue funding their care if the whole NHS CHC assessment process grinds to a rapidly approaching halt. Given the current state of uncertainty and stretched NHS resources, some with an existing CHC package of care will undoubtedly benefit from having their annual reviews postponed and avoid the potential risk that funding could be withdrawn. But, sadly for others, it could mean that they are stuck with a current CHC care package that is inadequate to meet their increasing healthcare needs. We shall have to wait and see how CCGs manage the crisis.

We do not know at present when the CCGs will be fully open for business again, but in the meantime, there are things that you can be doing in these difficult times:

1. Start to prepare your thoughts on paper for the MDT.
2. Collate your evidence and prepare your written submissions for an appeal.
3. Read our helpful guide “How To Get The NHS To Pay For Care” – available as an ebook/PDF to download or paperback.
4. Read around the subject and look at the many blogs written on the Care To Be Different. Browse through our website or use the search box if you are looking for a specific topic or issue.
5. Visit our Facebook page and read what others have said about their CHC experiences and learn from their issues.
6. Seek available guidance if you need it – email your enquiry to us at enquiries@caretobedifferent.co.uk
7. If you can’t find what you’re looking for on our website, use our Advice Helpline Service for more detailed and lengthier queries, and book a telephone appointment to speak directly to one of our specialist nurse advisors.
8. If you need professional advice visit our one-to-one page.