Following the assessment meeting, our nurse will consider whether it is necessary for us to apply for a full set of care records to be obtained and reviewed before producing a detailed report which we will send to you, setting out their assessment of you relative’s care needs. This report follows the same format as the Decision Support Tool (DST) used by the NHS when determining a patient’s eligibility for NHS Continuing Healthcare Funding.
The report will help you to understand, whether in our view, there is any realistic prospect of arguing that your relative should potentially qualify for NHS Continuing Healthcare Funding, and therefore to continue to Appeal.
If our nurse’s report concludes that your relative may not qualify for funding at the moment, you will be able to use the report as a baseline and for comparison purposes, when monitoring important changes in your relative’s condition, in case they meet the funding criteria at any future reassessment. Furthermore, the report will also give you the reassurance of knowing that the matter has been assessed objectively by a skilled nurse who has a wealth of experience in this specialised field.
If, after the Clinical Review Service, our nurse believes that you have a strong case, we can help you with your Appeal and are able to offer various funding options depending on the circumstances (subject to terms and conditions).
For appeals on retrospective reclaims and for deceased patients, we will start by offering our Records Review Service rather than the Clinical Review Service, which will enable us to determine whether we consider there to be reasonable prospects of success before embarking on the appeal.