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‘Secret’ deadline looms for ‘secret’ care home funding in Wales

  • July deadline has been ‘kept secret by NHS Wales’ say experts
  • The little-known NHS Continuing Healthcare benefit can help the most vulnerable, but with the clock ticking, hundreds of families in Wales will lose thousands of pounds
  • Families warn others ‘don’t take no for an answer’ (reader case study included)
  • Legal experts slam ‘secretive’ NHS for not doing more to promote the funding
  • Act now or lose thousands of pounds say experts

TIME is running out for people in Wales who have wrongly paid crippling care bills for elderly relatives to secure refunds worth thousands of pounds from a “secret” NHS scheme.

The average cost of a nursing home in Wales is £738 per week – that’s almost £40,000 a year.

Legal experts say families should act now to recover fees owed to them and are angry at what they say is a ‘secret deadline’ only revealed earlier this month online.

Every year thousands of family properties are sold in Wales to enable mainly elderly people to meet the costs of their care. But if the main reason for a person going into a home is ill-health they should be eligible for the virtually unknown Continuing Healthcare Funding, which means that the NHS covers all the costs, including accommodation. There is no ceiling on the amount that can be paid out, there is no means test and it is not age-related.

Anyone who is successful in claiming on behalf of a loved one could be entitled to have the payments backdated to April 2003, even if their relative is no longer alive. But applications must be submitted before 31st July 2014.

This is because the Welsh Government has announced a cut-off date of 31 July 2014 for applications relating to retrospective reviews for Continuing NHS Healthcare funding for the period 01 April 2003 to 31 July 2013.

Andrew Farley of specialist care funding solicitors Farley Dwek, which helps families secure NHS Continuing Healthcare Funding, said:

“If you, a family member or authorised representative were paying for care during the above dates, either in your own home or in a care home, you may be entitled to request a review of your or their needs during this time.”

“It’s appalling that NHS Wales appears to have kept this deadline secret meaning many people will lose out on thousands of pounds.

“If your relatives have been in a care home in Wales at any time since 2003 and you’ve paid out of your own pocket it’s worth double-checking to see if you are due a refund from the NHS. You may be entitled to a review of their needs. Millions of pounds have been set aside for families but not enough people are aware of it. It’s unfair of NHS Wales to do so little to promote it.

“Now the deadline is just weeks away and time is running out. Families in Wales have spent millions of pounds on care home fees unnecessarily. We are representing hundreds of families seeking to ensure their ­entitlement to NHS Continuing Healthcare Funding is being properly assessed, or recovering fees on behalf of those who have already unfairly paid for care in Wales.

“Local NHS Trusts in Wales have made too many mistakes regarding funding and it is important you get the funding you are entitled to and ensure your relative is assessed regularly if they are still alive but also recover fees they should never have paid if they have died.”

Continuing NHS Healthcare funding (also known as CHC) is the name given to a package of services which is arranged and funded solely by the NHS for those who have been assessed as having a primary health need. CHC may be provided in a range of settings including in a hospital, a hospice, a care home, or in a person’s own home.

CASE STUDY – Powys Local Health Board

‘Families should seek legal advice if they are in the same position as me’

Peter Shaw had to sell his mother’s home in Wales order to pay for her care home fees. Then, not long after her funeral he discovered that she should have received free funding from the NHS and was entitled to NHS Continuing Healthcare Funding all along.

Farley Dwek was able to recover around £44,000 of fees from Powys Local Health Board which were wrongly paid when his mother, Edna, lived in her local nursing home.

Mr Shaw explains:

“In 2006 my mother fell off a stool which resulted in her breaking her hip. At the time she was nearly 87 years old and she stayed in hospital for about two and a half months before we took the decision to transfer her to a nursing home where she lived until she passed away at the age of 88.

“When you’re researching nursing homes for your mother there isn’t enough time to consider whether she may be eligible for funding. You simply want the best care and focus on making sure she’ll be happy and comfortable.

“From day one we were asked to pay the fees and we paid each bill for the 18 months that she stayed in the home. It was a huge amount of money and obviously we were forced to sell her home in order to fund the costs of her care.

“After my mother’s funeral, I read something about NHS Continuing Healthcare Funding and felt I should investigate further. After doing my own research, gathering medical records and looking at my mother’s care plan I appointed Farley Dwek to handle my case.

“Farley Dwek reassured me that I had a strong case and always kept me in the picture with progress. It was a stress-free experience and the fact the service was provided on a no-win-no-fee basis meant I could proceed with peace of mind and avoid running up expensive legal bills.

“Families should not give up – and they should recover what is rightfully theirs. More people should claim NHS Continuing Healthcare Funding. Getting it right in the first place will save other families the heartache of having to sell property to pay for care home fees. The system is wrong and needs looking at. It relies on naivety and ignorance from families at a time when they are vulnerable and simply want to focus on the best nursing home for their mother or father.

“Too many people also want to close the book on a traumatic experience and don’t want to see if they are eligible for reclaiming care home fees. I would urge families who feel they have a case to take legal advice to see how they can recover these fees. My mother died when she was 88 and I’m sure she’d be pleased to know her family was eventually able to reclaim what was rightfully theirs in the first place.

“If a relative of yours is going into a care home or nursing home, I’d recommend getting specialist legal advice like I did.”

Andrew Farley of Farley Dwek, said:

“We’re pleased we got a good result for Mr Shaw and his family and recovered the fees that were wrongly paid all those years ago. It is important that families who currently have relatives in care take action if they feel they too may be entitled to NHS Continuing Healthcare funding. We’re proud we are able to help families like Mr Shaw’s to recover this money which is rightfully theirs. We know there are thousands of other families out there who are unaware that their mother, father or elderly relative should be receiving this funding. Hopefully, we are doing our bit to shine a light on this little-known area of NHS funding.

“Mr Shaw is quite correct, the system is wrong and relies on ignorance and an unwillingness from families to look more closely into the detail of their relative’s care plan and medical history.

“Applying for NHS Continuing Healthcare Funding is no walk in the park. It’s confusing, emotional and complex. We’re happy that we’re providing a much-needed service for families in Wales.”

Download your free guide to NHS Continuing Healthcare Funding at www.farleydwek.com

See http://www.wales.nhs.uk/sitesplus/867/page/72988

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