NHS Continuing Healthcare Independent Review Panel - how independent is this really?
You may have hit a brick wall at a local appeal for NHS Continuing Healthcare, and you want to take things further. Your next step is a Continuing Healthcare Independent Review Panel (IRP) hearing.
This is a regional level appeal and involves a panel with an independent Chair plus members of health and social care from outside your area. It’s supposed to give you the opportunity to have your Continuing Healthcare appeal reviewed by people who weren’t involved before.
However, we’re hearing increasing accounts of Continuing Healthcare Independent Review Panel meetings being less than independent. Families are coming up against the same flawed arguments, incompetence and obstruction as in the local appeal process.
As well as involving people from outside the area, many IRPs now also seem to invite the same local assessors whose maladministration led to the appeal being needed in the first place. The IRP can turn into a battle of ‘their word against yours’, which is hardly the independent review it should be.
This article is not to discourage you from pursuing an IRP. People do win. Our aim is to highlight what you may come up against – so you can prepare for it and keep labouring every point the Panel may want to simply dismiss.
David contacted us about his mother’s recent IRP. He recounted what happened in the meeting – and afterwards. He shares his story here:
“My sister and I attended the IRP meeting and were very optimistic at the end of it. The Chair of the meeting had said that he was impressed that we had prepared such a good case. Additionally, the representative of the local NHS Trust Continuing Healthcare Department (who said she had nothing to add when asked to comment on our case by the Chair) remarked after the discussion was over that, with cases like ours, it’s pretty obvious what the outcome would be.
We took this to mean that the Trust had decided not to oppose us, and that they thought the IRP would overturn the recent decision to refuse funding.
We had taken with us a 10-minute video of our mother, which seemed to have a profound impact on the three Panel members and Clinical Advisor. It showed our mother to be unable to communicate and to be completely reliant on others for all her needs.
But our optimism was dashed when, eight weeks later, we received the notification saying our mother did not qualify for Continuing Healthcare funding! The same language used in previous rejections was used to justify the decision: “Her needs are merely incidental or ancillary to the provision of accommodation and of a nature which an Authority, whose primary responsibility is to provide social services, could be expected to provide. Consequently she does not have a primary health need.”
Our challenges in respect of how, according to NHS definitions of social need versus health need, our mother had a health need, were ignored. And our challenges around the Behaviour domain where previously it was interpreted as aggressive behaviour (contrary to NHS definitions which specifically mention the passive self-neglect behaviour of dementia suffers) were also ignored.
Behaviour was again defined as “verbal or physical aggressive behaviour such as biting, scratching or hitting out”. The IRP went on to say, “The Panel noted that the dictionary definition of behaviour was the way in which a person behaves in response to a particular situation or stimulus. This suggested that some type of response or reaction was needed in order for this to be considered as behaviour.” On this words fail me!!
They are making up domain definitions however they wish – from the dictionary!! What they should be doing is using the very precise definition in the NHS Continuing Healthcare documents. I did refer them to this in writing and verbally at the meeting.
We don’t know who had the biggest input to the IRP decision but we are sure that the member of the Panel who acted as Clinical Advisor took offence at us referring him to the definitions in Continuing Healthcare documents during the discussion, when he was constantly getting his definitions (particularly around behaviour) wrong.
They did move the Behaviour domain up from No Needs to Low, and the Nutrition domain from Moderate to High, but that was all. However, our main argument was not what domain scores she gets but the fact that the very descriptions of her condition in NHS documents show that (by the NHS’s own definitions), she has a health need not a social need. But those arguments were not addressed.
We are now convinced that the IRP is not ‘independent’ at all. The arguments used and the errors in assessment made were identical to the two previous local Panels – right down to the wording used to reject her case. And, as before, nobody on the IRP seemed to show the slightest interest in using the NHS’s own published definitions, but would rather use their own arbitrary ones.
We are obviously now going to the Ombudsman, however we wonder if they too will be part of this same conspiracy to stop any dementia patients getting Continuing Healthcare funding.”
Have you taken your case to an NHS Continuing Healthcare Independent Review Panel?
If so, what was the outcome for you?
Thirteen months on and still no progress, my Mum remains in hospital, due to my Mum’s numerous health problems including Alzheimer’s my Mum is oblivious to this. Reflecting on events to date, it beggars belief what we have endured. The two governing bodies that should have my Mum’s best interests at heart (NHS & LA) have failed my Mum. I won’t go into great detail as you would need hours and hours to read it. I am standing my ground, my Mum deserves respect, dignity and justice. I would be failing as her only child, should I not take this stance. One very important factor, if you do not have power of attorney, do so now. Hindsight is a wonderful thing and due to my Mum’s mental health I am unable to obtain this now. I will not be deterred, despite all that has been thrown at me so to speak. Numerous questions have been asked to both NHS & LA, they are selective and evasive as to what they answer, no surprise there then! After 11 months they finally realised that I was not giving up so produced their lowest attempt to derail us by threatening me with ” Court of Protection” for my Mum.
I contacted the IRP, returned the relevant forms that they sent to me. I never had any response what so ever. When I was threatened with the Court of Protection, I emailed IRP asking them if they were prepared to go forward with my Mum’s case and advising them that I had been summoned by CCG/LA to a ‘best interests’ meeting and we had been threatened with Court of Protection. No response. Two weeks later I emailed them again, referring them back to my previous email. I finally received a response stating that they had sought further information from CCG And have decided that it was not appropriate to arrange an IRP at this time. The reason given was that because the best interest meeting has made a recommendation that CCG complete their processes. NHS England therefore will take no further action on this case. No reference was given in relation to Health & Parliamentary Health Ombudsman I was advised to contact NHS complaints procedure.
I responded stating that I was very disappointed that no approach was made to me to obtain any detailed information, yet IRP felt the need to approach CCG to obtain information. I stated that this leads me to question the word ‘Independent’ contained within the tittle of Independent Review Panel. I asked other questions and stated that it is very sad state of affairs when NHS/CCG and LA fail to comply with their own legislation let alone the law. Needless to say I await to this day for a response.
I am now in the process of collating all documented evidence to sent to Health Palrliamentary Ombudsman. I am very cynical due to our experiences but here’s hoping justice prevails. If this course of action does not produce a positive outcome, I will investigate court procedures. I will go public with everything, locally and nationally as the general public should be aware of this national disgrace and people should continue to promote public awareness until this is addressed in Parliament. I do not want any family having to endure what we have. My health has been compromised due to the actions/inaction of NHS/CCG and LA. Thank goodness my Mum is oblivious to this. I will continue to seek justice, any feedback would be welcome.
Maybe worth reminding your mum’s ‘social worker’ about the Code of Practice for Social Care Workers:
3.1 Promoting the independence of service users and assisting them to understand and exercise their rights;
3.2 Using established processes and procedures to challenge and report dangerous, abusive, discriminatory or exploitative behaviour and practice;
3.3 Following practice and procedures designed to keep you and other people safe from violent and abusive behaviour at work;
3.4 Bringing to the attention of your employer or the appropriate authority resource or operational difficulties that might get in the way of the delivery of safe care;
3.5 Informing your employer or an appropriate authority where the practice of colleagues may be unsafe or adversely affecting standards of care;
3.6 Complying with employers’ health and safety policies, including those relating to substance abuse;
3.7 Helping service users and carers to make complaints, taking complaints seriously and responding to them or passing them to the appropriate person; and
3.8 Recognising and using responsibly the power that comes from your work with service users and carers.
We’ve just heard that another of our clients has achieved success in obtaining NHS Continuing Healthcare funding – and this was at an Independent Review Panel hearing. So, although there’s a lot that goes on that shouldn’t in this process, people nevertheless are successful in securing funding via this route.
I am so sorry to hear of your situation Sylvia. The more stories I hear and the more I read, fills me with complete horror and disgust. I sent a detailed letter to the Chief Executive of Social Services, asking numerous questions. I stated that I am of a firm belief that they are abusing their powers and in doing so infringing my Mum’s Human Rights. I received a response, which is a first! They refuse to answer my questions until after Court of Protection have made a decision, obviously hoping COP will rule in their favour. I can predict what will happen then, they would inform me that they don’t have to answer my questions as i no longer have a say. It would not come as any surprise to me if the ruling went in their favour as I dread to think of the image they are portraying of me. Whatever it is has to be fabricated or as you say twisting things to suit, despite the fact that I have documented evidence and witnesses to incidents that have occured. IRP did not act in an independent capacity which continues the set pattern. I am so cynical now, which goes against the grain as I believe I am a very fair person and analyse from all aspects. HPO is my next stage. It is a dreadful situation to be in, we should be confident when approaching authorities that we will be treated fairly with transparency and honesty.
I am not aware of all the facts of your situation but I have through research obtained some information with regards to my Mum, maybe they would be helpful to you.
Section 6 of the human Rights Act – DUTY ON PUBLIC AUTHORITIES
It is unlawful for a public authority to act in a way that is incompatible with a Convention right.
Section 8 – a right to Family Life, this is a Qualified Right, limitation must be:
In accordance with the law
Necessary and proportionate, proportionality:- actions and decisions must be appropriate and not excessive in the given circumstances.
Alternative approaches to the problems that were less drastic have not been considered.
In other words don’t try to crack a nut with a sledgehammer.
I don’t know if your Mum has an Independent Mental Health Advocate to work with you in protecting your Mum’s rights and her best interests. I was never notified that this was an option by my mum’s Social Worker and found out through research. I am now exploring this option.
Maybe you are aware of the above, I know I am always so grateful for any help or suggestions offered, as it is a very lonely road we walk when dealing with NHS and Social Services. Good luck Sylvia, I wish you well.
Thanks for sharing your story Sylvia. You have questioned whether families could work together on this. I am interested to know if any attempt at a class action re reimbursement of funds for people with Alzheimer’s has ever been made? It might save everyone time & money.
If you’re looking at what may have been done in the past specifically for people with Alzheimer’s, Helen, it may be worth contacting one of the national Alzheimer’s groups or charities – to see if others have asked this same question.
I attended an IRP yesterday. Present at this meeting was an independent chair, a social worker and continuing care nurse from the same region making up the panel. The CCG sent two continuing care nurses (the head and the nurse who did one of the DSTs) and there was myself and my two siblings. There was also an administrator from NHS England making notes. Both sides had submitted statements but these were not gone through, which is a pity because we had found some errors in the that of the CCG. The format the chair chose was to run through the procedural errors mentioned in our statement and then ran through where we disagreed on the DST levels. This probably seems reasonable, but it wasn’t quite what I was expecting, so I felt wrong footed, and felt I didn’t put our arguments about well managed needs in the behavioural domain across strongly enough. My concern was that the social worker and nurse on the panel probably have been attending the same training and benchmarking sessions as the two nurses from the CCG, and although they were independent in the sense they had no contact with our case, they perhaps were not independent in their thought about the National Framework and law concerning Continuing Care. I had requested the meeting be held in another region, closer to my home, but this wasn’t allowed.
My appeal has just failed at local level and the letter I received said I could appeal to NHS England. There were no timescales . Does anyone know how long you get to put in this appeal?
An update on our IRP held in May: Our appeal failed. We are considering if it would be worth of while to try the Ombudsman. Can anyone advise if this requires a lot of work? Are we still likely to feel like we are banging our heads against a brick wall?
Three days ago I represented my late mother at an IRP which was requested last October. It took a few reminder letters before I had a response to my appeal letter, I think perhaps they were hoping that I would go away since my mother had died.
Having followed your advice, at the start of the meeting I did ask the panel about their qualifications and training, they were all very quick to tell me about their qualifications and years of experience, but they did not mention their training in relation to CHC.
The chair person summarised my case reasonably well and then asked me why I thought my mother should have qualified for CHC. I replied by saying that both in totality AND nature her needs were beyond the legal limits that a Local Authority could provide and were certainly not incidental or ancillary to her need for accommodation. I also pointed out the she had scored one severe four highs four moderate and two low needs, and that I was also disputing the drugs domain as I felt that it should have been scored as severe. I pointed the pannel in the direction of section 31 (establishing a primary health need) and suggested that as she already had been scored as having one severe and needs in a number of other domains and as such it was more likely than not that she did qualify unless they were able to give clear reasons as to why not. The chair was very quick to point out that it only says ‘MAY’. However, I suggested that I did not feel that I had been give VALID reasons as to why she didn’t qualify. The chair quickly moved on with no further comment.
We moved on to why I thought the drugs domain should should have been scored as severe, I explained that in psychological and emotional needs she had been scored in her medicated state and that this should be reflected in the drugs catagory. She was on antidepressants and antipsychotic medications along with other important medication, she lacked concordance and without her drugs she would most certainly have been at risk of relapse.
The chair went on to say that she had recently had a memo from the Department of Health relating to this, and said that they would not withdraw drugs. She offered no further explanation athough I asked why it was relevant as I wasn’t suggesting that they were likely to stop her drugs, and that the way this should be viewed is what would happen if the care were removed not the drugs. The chair again made no further comment. I emphasised that the words are there, written in black and white and that the NHS can’t change them just because they don’t like them. I felt that the pannel were not happy, but having read your book I felt empowered and stuck to my guns and will await the outcome, which from previous experience is not really optimistic. I feel certain that these reviews are little more than a paper exercise in an endeavour to prove that they have followed the rules!
Chris French
Ask for training records in direct relation to Continuing Healthcare. If they don’t have them they can’t win in a court of law as they were not trained and negligent. 90% of assessors have not been trained in this specific field and thrown in at the deep end as one told me in a meeting. A judge in a court of law will want to see training records just like they rely entirely in court on expert witness statements or reports. If they don’t have the training and you can prove it they fail. End of story!
IRP…with respect to Retrospective Review of Continuing Healthcare (CHC), are there any restrictions about evidence to be used by this Independent Review Panel? My mother’s original claim way back in Sept.2012 was flawed by selective use of medical evidence and I am still waiting for a result from the “dissatisfaction” team who may well use the same tactics. I have well over 100 pages of evidence including GP, Psychiatric, Care Home and CCG notifications plus results from other CCG’s which are very revealing as to where the money has gone. Would the IRP consider exposing flaws in the system which lead to an incomplete and unfair review or is it the case that the IRP will select what they want from the CCG and myself and draw their own conclusions.
I have today received the result of the IRP meeting to decide on my appeal against the refusal of the CCG to grant my mother Retrospective Funding for the period between November 2009, when she was discharged from hospital to a care home, and March 2010 when she was assessed and immediately granted Full Funding. The IRP upheld all my complaints against the abysmal and obstructive practice and procedure adopted by the CCG during the appeal, but then effectively re-wrote the original DST, scoring lower in several domains and dismissing the four key indicators, which I consider specious, illogical and perverse. But where do I go from here? From what I have read I have no confidence in the Ombudsman who will surely just rubber-stamp the IRP decision. Were I a cynic I would conclude that the whole process is budget-lead with no regard for responsibility or duty and that the IRP procedure is complicit in this.
Thank you but your link just confirms that many others are just banging their heads on their own brick walls. In “re-writing” the original DST the IRP, unlike the original Assessor, did not have access to the Care Home records because they had since been destroyed. I agree that their arrogance in presuming to know better than the original Assessor was truly outrageous. The IRP agreed that there was no evidence that either a Checklist or a DST had been prepared when mother was discharged to the Care Home. Nevertheless they ignored my point that paragraph 74 of the National Framework should operate and the CCG retain responsibility for her funding. Doubtless they would argue that, as they had marked her down, funding would not have been “appropriate”. I would like to have a Judge look at this matter but funds do not allow!
Since posting the above I have read that a fund was set up for Retrospective Continuing Healthcare Funding but that it has been exhausted and there is no money left. If so, the process has become a hoax and should be exposed as such. It would certainly explain why the Independent Review Panel (IRP) condemned the obstructive CCG process but then denied my claim, because it would have cost the NHS money which they don’t have. Has anyone won before an IRP in the last three months?
I recently attended an Independent Review Meeting (IRP) Meeting for a retro-claim for my Father who had Dementia as well as other chronic medical conditions. The claim has gone on now for five years and my Father has passed away. We are going to pursue the claim – as the IRP said he was not eligible despite getting: criteria scores of: 1xSevere, 2x Highs, 6x Moderates and 2 x Lows, 0 x Other.
They refuse to accept that they should have paid for my Father’s care despite their reports saying that the Multidisciplinary Team (MDT) made the decision that he required go into a Nursing Home – not a Care Home.
As other people here on this blog, we have several ring binders full of Medical Notes, GP, Social Services, Hospital Records, Pyschiatric Reports and Letters, Nursing Home Notes – etc etc.
When discussing this with the IRP Meeting attendees – CCG People (Ex-NHS Nurses and an “Independent” chairman), they argued that – despite serious health issues, my Father’s Needs were not beyond “Routine Care” and there was nothing complex or unpredictable in the period of the claim – from 2010 to 2012. But witihn that period – soon after an assessment which said his Mobility Needs were “LOW”, he fell several times and had fallen and been hospitalised before even going to the Nursing Home, but because these records were not at the Decision Support Tool (DST) Assessment, and becasue the Home did not have his Notes, the Needs were all marked “Low”. the very next day in the Nursing Home Notes he fell, and kept on having falls over the next few months which resulted in a Hospital Admission – after which he never walked again and caught a Chest Infection – made worst by Dementia and COPD. He nearly died in 2012 from lack of mobility and malnutrition. This period leading up to this was said to be “Routine Care” and not complex, despite Behavioural problems and Severe Cognition problems.
When he entered the Home – he had not been assessed for Continuing Healthcare (CHC), and we had to pay for his Nursing Care. The first CHC assessment was not done until three months after he had entered the Nursing Home as a resident and was self funding.
The IRP refused to discuss the period prior to his Admission to the Nursing home -even to get some context of his Needs and why it was necessary for him to have Professional Nursing Care. They refused to discuss the fact that an Health Needs Assessment (HNA) was requested months before his final admission and that both Social Serives and GP Practice had failed to follow up on the HNA request,with the GP blaimng the failure on a Locum Doctor – who left the GP Practice, presumably with the responsibility of the HNA too.
Despite many of the first CHC Assessment Needs scores being increased, they still said what a wonderful Nurse Assessor the person was who chaired that first MDT Meeting in the Nursing Home. She ignored my father’s record of falls, COPD, Behavioural problems, assumed if a need was Managed, it was no longer a Need, and tried to make it look as if my Mother was to blame for my Father having to go into a Nursing Home, implying that she failed to look after my Father Properly – this was mainly emphasised by Social Services who suggested a Private Nursing Home specialising in Dementia – but after 30 minutes had called the Police as they couldn’t manage him, and then called my Mother to pick him up – 3 days early – leaving my Mother without any respite.
The IRP Report looked like it had been modified from a standard document template – as they called my Father Mrs Jones on some pages, has anyone else had the same feeling about the IRP Reports? The Report was very repetitive and kept repeating the same phrases over again in different sections. Does anyone think that the IRP Report is clear and well put together? It didn’t seem to clarify to me why they thought my Father did not have a Primary Health Need as they said indicated that he was in a Nursing Home for Accomodation and medical treatments were purely ancillary to accomodation where it was the other way around as he owned his own house. (White is Black, and Black is White?)
We are now compiling a complaint to the Ombudsman – does anyone have any experience of Ombudsman Applications?
It’s still government so would assume it’s still going to be instructed to be just as biased as the CCG.
Thank you,
Conrad.
After 8 years of fighting my now late Fathers claim for CHC funding, the Independent Review Panel is scheduled to take place this Thursday 30th July. The original date in March was rightly postponed because of COVID.
The Panel meeting is now happening ‘virtually’ via Microsoft Teams …obviously my preference would have been to attend a ‘face to face’ meeting though understand that this now the new way of working.
Does anyone have experience yet of attending these important decision making IRP’s this way? If so , what should I expect and are the meetings organised differently than before as a result? What happens to the paper evidence that is normally visible and available? Any tips will be gratefully appreciated. Thank you Mike
Mike. Clark. how did your teams meeting go. we are fighting against doing this a we want a face to face meeting. We were advised that quarry house in Leeds was closed however we found out that it was actually open. We have waited 10 years for this and my mother died in 2012.
Could all of us in this situation chase our local MPs? When our family’s saga began I was in contact with M Gove, and I am even more worried now as I have had one dispiriting standard letter back from M Hancock (all pre Covid). I realise they are otherwise occupied currently, but couldn’t all of us canvas all of our local MPs whom some of us in each constituency voted in (I did not vote for M Hancock incidentally)? Could we exert group pressure across the country and/or the UK? There must be so many relatives in this exhausting situation, surely together we have some influence?
My brother and myself were recently advised that instead of a meeting that the IRP would now take place 1st september by Microsoft teams. I cannot see a change in leglislation to allow this method to be used. NHS England when questioned about this advised that this method was used since march 2020 but waited until recently to advise us that this would be the method used . When we questioned why we were not advised in March and yet they were unable to answer why. My brother and myself agreed for Bassetlaw CCG to obtain notes regarding our mother in 2011 and again in 2015 regarding soccial service and mental health records. Bassetlaw CCG then transferred the informatiion to doncaster CCG and they have refused to supply the information to us. They determined one period and actually agreed that we would be reinbursed for this period. and advised Bassetlaw CCG to reinburse us this period. My brother and were final paid out in late 2018 and we requested that our soilictors invoice be paid and also that given the time period interest at 8% should have been paid. Bassetlaw CCG advised us that the case was not exceptional and therefore they would not pay our solicitors fees etc however they inadvertently included an email from Doncaster CCG/purpoc team indicating that Bassetlaw were discussing for some unknown reason with the purpoc team as to whether to pay us the fees etc. It indicated that only in exceptional circumstances would solicitors fees be paid which our mothers case was. However they then advised Bassetlaw CCG that no one had ever been paid out there solicitors fees so therefore it is impossible not exceptional to get your fees paid. We are now proceeding with a claim for an earlier period and both Bassetlaw CCG, Docaster CCG/purpoc team /NHS England , NHS ,appear to be working together to prevent any further claim been paid. most people would give up. and that is exactly what they want. The entire process is biased in favour of the NHS.
Hello all,
Is there anyone on this forum that has actually been successful at the IRP appeal? If so, may I ask how you presented your case, and would you have a sample copy you would be prepared to share with others here, obviously with the personal information removed, I would dearly love to read a successful appeal, I have to get ours in by 7th October this year, can anyone please help?
Thank you so much
Mrs G Clark
Mrs Clark
Thank you for your reply and I am wishing you all the best for your IRP meeting.
I think you are doing the right thing in getting professional advice before the meeting. In hindsight, I wish I had done the same thing before the IRP as like you I have been leading the case for 8 years and feel too close to it.
What I have found throughout is that even though the DST domain ‘scores’ indicate ‘primary health need, the CCG and then the IRP apply what they call their ‘professional judgement’ that the interaction between nature, unpredictability, complexity and intensity was not sufficient enough to justify CHC. In my late father’s case, and likely to be the same with your father’s needs, this is because the interactions were ‘well managed’ by the nursing care received and the interventions provided. Without this, my late father would have been admitted to hospital more frequently, against his wishes, and would have basically cost the NHS more money (£650 per day I believe for each day in hospital).
The assessors chose not to apply the ‘well managed need is still a need’ test in their decision making, and do not take into account the family evidence either …conveniently so I believe.
So, if you use a CHC assessor, I would ensure they know how to make a compelling case for the 4 interactions to work in your favour.
I have now sent my Complaint on this basis to the PHSO though not expecting a positive response…have you seen the reviews about the PHSO?…all 1 star and so much negativity about their role and bias towards the NHS.
Please keep me posted regarding your fathers case. Good luck and fingers crossed.
Best wishes
Mike
I can relate to this also. I realise it’s an old article but where it says “that the member of the Panel who acted as Clinical Advisor” – is this actually allowed? I had the same experience recently at IRP, where a member of the panel making the decision was also acting at the Clinical Advisor. But is this not a conflict of interest? Does anyone have any knowledge or advice? Thanks
Our case goes back over 12 years. Following the latest review which was heard without my brother and attending and we were again awarded our claim and therefore the NHS were going to pay for all but a few months of our full claim. We challenged this with NHS England and was advised that they would come back to date years after they have not come back clearly our experience of NHS England is not fit for purpose. We went to the PHSO and again the same procedure after over two years no response they to are not fit for purpose. Whilst this was going on we contacted our local CCG for payment of the second payment and they sent a document for us to sign agreeing that this was full and final payment of our claim .We signed the document but added that it was not full and final payment and they refused to pay. This is yet another body that is not fit for purpose. Does anyone have a solution to this when all of these talk to each other. We have considered sending the baliffs into the CCG to get our payment . The entire process is designed to wear the individuals who claim down.
I think that some legal basics need to be considered in relation to IRP panels. As a lawyer, the first golden rule is that you cannot sit on an appeal against your own decision. That must be decided independently. I had a social worker excluded from my father in law’s checklist because she had previously told me that I would not succeed and so the ICB had to find another one. I also succeeded against the Valuation Office Agency in this regard. What worries me about some of the information given in the posts on here is the suggestion that although an original MDT assessor or even a Local Resolution panel member was present at the IRP, they should never be a joint decision maker. If they are merely sitting in to assist the panel with the ICB standpoint, then there is nothing wrong with that if the applicant or their representative or their solicitor is on the other side to make representations against the ICB.
I have my own cautionary tale to tell in relation to the MDT assessment which I attended. My brother, a retired clinical director was there to help me with the medical side but when we arrived, the social worker who had conducted the Checklist and a senior carer were present. It became apparent when I received a copy of the DST that the Overview was almost entirely factually fictitious and conveyed a completely false impression of my father in law’s abilities prior to him being admitted to hospital and thence to a care home. The lead assessor had never met him prior to that morning of the MDT and there is no way that he would have been capable of giving her the false information in any sort of cogent form having been assessed as seriously mentally impaired. So either the lead assessor made the Overview up or the information came from the social worker or from the senior carer. I doubt if the first scenario could be true and I think that it might well be serious professional misconduct for the social worker to have told what were essentially lies. But the senior carer had been overheard in the care home expressing opposition to my application and also had informed my father in law, even though he had no grasp of what CHC was, that the application had no chance of success. At least he remembered that. So who knows who bent the ear of the lead assessor before we arrived at the meeting so that we had no chance until after the CHC decision had been made by the ICB and the DST copy supplied to me, of correcting falsehoods. But I have my suspicions about what occurred.
So, going back to the IRP, I think that applicants should be prepared to ask some serious questions about the role of any of the previous assessors being present at the IRP and what if any information has been given to the IRP in private before the meeting. And also of course what role it is intended that those assessors should take in the meeting. I would have no compunction in telling the panel that if they were to allow any previous decision maker to effectively sit on the appeal, they will almost certainly be breaking the law in that in a Judicial Review, the IRP decision would be set aside.