Beacon overturns policy that left families unable to fight for funding

Posted on: June 17th, 2022 by JS

Earlier this year, we were alerted to a situation faced by two families who had contacted us for advice.

Both callers – who were under the jurisdiction of the same Clinical Commissioning Group (CCG) – had loved ones who had been turned down for NHS Continuing Healthcare (CHC) funding. Both wished to challenge the decision, but had been blocked from appealing because they did not hold a lasting power of attorney (LPA) for Health and Welfare.

We knew this wasn’t right.

Principles set out in the CHC guidelines, to which every Clinical Commissioning Group (CCG) in England should stick to, make it clear that a person’s representative (e.g. carer or close family member) can appeal a decision if they are acting in the best interests of the individual concerned. And it would usually be in the best interests of the individual for that appeal to be accepted.

So, was this practice simply an isolated case of a single CCG misunderstanding the rules? It appeared not; a letter received from the CCG by one of the callers stated that this policy (of blocking an appeal when no LPA was in place) was consistent with another CCG in the region.

Very worried by this trend, we took the matter directly to NHS England. They agreed with our concern and rapidly took the matter up with the CCGs in question. One week later the policy had been scrapped and the CCGs will be progressing all appeal cases even with no LPA, based on the ‘best interest’ principles.

The CCGs in question will be contacting all families who fell foul of their previous policy, and they will now be able to appeal their CHC decision if they wish to.

Dan Harbour, Managing Director of Beacon, said: “Alongside our free advice and casework with individuals, we are proud to help more families now and in the future by pushing for change at the heart of the system.

“Our close-knit team of expert advisors, and the high number of CHC cases we deal with each week, means we can quickly identify and act on new issues faced by families around the country or even in an isolated region. We’re delighted that this practice of unjustly blocking appeals has been ordered to cease at the CCGs in question and are making sure that our callers and clients are aware of their rights around this issue. We will continue to raise any concerns we have around consistently poor practice in individual CCGs with NHS England and Improvement.”

How we can help

Our expert advisers can answer your questions on any aspect of NHS Continuing Healthcare in England. We have helped thousands of people to understand the eligibility criteria, navigate the assessment process, understand the Decision Support Tool and your assessment, review a decision, or begin an appeal. We can also talk to you about funding policies and issues in your area.

Contact us by visiting our Talk to Us page and completing the contact form, or call 0345 548 0300 during office hours.

 

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