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Continuing Health Care Appeals
Nellie Supports registered, qualified Social Workers specialis in adult Social Work and have vast epxerience comepltign contiuing health care assesments, DST (decision support tool) Meetings and the appeals process.
How can we help?
Nellie Supports can help you every step of the way
Your Questions Answered
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What is Continuing Health Care (CHC)
NHS Continuing Healthcare funding is available to adults living in England who have particularly intense, complex or unpredictable care needs. Unlike local authority funding, it is not means tested. NHS Continuing Healthcare is a fully-funded package of care that some people are entitled to receive as a result of disability, accident or illness. It covers the full cost of the person’s care and residential accommodation.
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Continuing Health Care Checklist
The NHS continuing healthcare checklist is a practical guide that assists professionals to accurately identify individuals who may be eligible for NHS continuing healthcare funding. This assessment tool can provide valuable insights in multiple scenarios and can be used to determine if an individual should progress to further assessment of eligibility.
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Decision Support Tool Meeeting (DST)
After a positive CHC Checklist, a comprehensive continuing healthcare assessment will take place in the form of a DST meeting. This doesn't guarantee that the individual will receive funding, but it is the next necessary step in the process of identifying whether a person is eligible for NHS funding. Normally a decision will be reached at the end of the DST meeting.
The Local Integrated care Board (previously CCG) will assign a nurse to organise the assessment and solicit contributions from other health and social care professionals. The nurse and their teammates (the multidisciplinary team) will analyse all of the evidence regarding the patient's wellness needs by utilising a Decision Support Tool (DST).
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CHC Appeals
The Local Integrated care Board (previously CCG) decision can be appealed within six months of receiving the notification letter. After that, the Local Integrated care Board has three months to appraise and finalise the local review phase. This process can sometimes take up to a year, but the exact duration depends on geographical location. After that, you have another six months from the time of being notified to request a review via an Independent Review Panel (IRP). Once your request is received, NHS England must convene this IRP within three months. Three decision makers will work together to decide on the outcome - an independent Chair along with one health and social care professional not associated with the original Local Integrated care Board who made the decision.
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Why Choose Nellie?
Nellie Supports are different to other providers; as Registered Qualified Social Workers, our team can not only support you through the entire process, they can complete their own independent assessments to feed in as evidence to DST meetings and CHC Appeals.
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Whats included?
It depends on each individual; if you are querying whether someone could meet the thresholds for Continuing Health Care funding, then our team can complete a care assessment and checklist to ascertain the viability of a funding application. If you have been rejected, we can collate information and complete new assessments to support you in an appeal. Everyone is an individual, and every approach we take is unique.
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Why a Social Worker?
Whether in a hospital setting, the community or a care home, as part of a continuing health care application is a DST Meeting (decision support tool); this meeting is attended by a Nurse assessor and a Social Worker. As such, we utilise the experiential knowledge of our Social Workers to ensure that whether it is support at a DST or with completing a Continuing Health Care Appeal, this knowledge and experience is invaluable. Additionally, as registered Social Workers, our team are able to collate not only evidence from social and health providers but also complete independent assessments themselves to use as additional evidence.
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Can we complete video-link or face to face assessments?
We can visit you in your own home or any other suitable space you feel most comfortable and at a time of your choosing. In those instances where face-to-face assessments aren't viable, we offer a fully secure video-link assessment service.
Accreditations
Social Work England is a specialist body taking a new approach to regulating social workers in their vital roles. All of our Social Workers are registered with Social Work England for your peace of mind.
Our assessors are accredited Montreal Cognitive Assessment (MoCA) assessors with specific experience in completing capacity assessments and specialist reports.
All of our assessors have undergone extra training to become accredited financial vulnerability experts according to Lichtenberg standards, so they can provide even more detailed reports on mental capacity.
CASE STUDY
Anne's mother, Dianne, had been living in a care home for the past five years after being diagnosed with Alzheimer's dementia. Anne's condition had become progressively worse over the past several years, and for the past three years, she had been aggressive towards care staff, suffered from double incontinence and had severe bouts of depression.
Anne's local authority social worker completed a continuing healthcare checklist and identified that Dianne met the criteria for a decision support tool (DST) meeting, howver this never happened. When Anne contacted the social work team to chase this up, she was advised they were waiting for an appointment date to come through.
Two years later and Dianne was still self-funding her care, and no DST had taken place.
Dianne contacted our team, who completed their own full adult social care needs assessment and a speculative CHC Checklist. With this evidence, contact was made with Dianne's local authority and local Integrated Care Board, and a DST date was organised along with representation from the local authority.
Dianne and Anne were represented at the DST by our Social Worker, and a successful agreement that Dianne's care would be funded was reached; however, that wasn't quite the end of the story.
Our Social Work team was able to make an appeal on behalf of Anne and Dianne to apply for the funding to be back-dated, resulting in nearly two years of care fees being repaid to Dianne.
