Six month deadline for retrospective funding decisions is confirmed by Ombudsman

Posted on: January 17th, 2017 by Jane Shepley

Late last year an issue was brought to our attention by callers to our helpline. They told us that Clinical Commissioning Groups (CCGs) were giving them very little time to appeal retrospective NHS continuing healthcare decisions.

We still get calls from people who requested a retrospective assessment as far back as 2012. They wait years for the assessment, often with little communication from their CCG, only to be sent a huge and bamboozling report that concludes their loved one wasn’t eligible for funding.

Unfortunately, because of the backlog of retrospective requests, this is a common tale. However, we were shocked that some callers were now telling us that they had been given just two weeks to appeal the decision.

The official guidance

Back in 2012 the Department of Health announced a six month timeframe for people to appeal continuing healthcare decisions. Recently, it seems, some CCGs have told patients that this only applies to current cases, but we thought that this sounded unreasonable.

We raised the issue with the Parliamentary and Health Service Ombudsman and were glad they could confirm what we suspected; that everyone should have six months to appeal a current or retrospective NHS continuing healthcare decision.

We think that this gives people reasonable time to digest the report, decide if they want to appeal and, if so, to gather evidence and to seek help if they need it.

An approaching deadline

The deadline for completion of the retrospective assessments is 31 March 2017 so we expect many more people to receive their eligibility decisions over the coming weeks.

If you have been given a short deadline to appeal a retrospective decision you can challenge it by writing to your CCG to say that the Ombudsman’s intention is that everyone has six months to appeal.

If you need help or further advice, please call our free Information and Advice Line.