Clare’s Story

We were instructed by ‘Clare’ in relation to her father, ‘Geoff’s’ claim for NHS Continuing Healthcare Funding (CHC).

Geoff was assessed at a Multi-Disciplinary Team Meeting (using the standard DST) in April 2019 and found NOT eligible for CHC Funding.

The decision was appealed by Clare. She had also requested the NHS Clinical Commissioning Group (CCG) review earlier and later periods of care, including the period up to her Father’s death in August 2019. However, these requests were declined by the CCG on the basis that Geoff’s needs were the same as those identified in April 2019, for which the patient had already been found not eligible.

Clare bravely dealt with the appeal at Local Resolution stage herself, but the CCG upheld their original recommendation and found that her Father was not eligible for CHC Funding.

Clare subsequently lodged a request for review with NHS England. She instructed Farley Dwek at that stage to represent her at the Independent Review Panel (IRP) and to consider further periods of care which the CCG (now renamed ICB) had refused to review.

Our expert team reviewed the full case file and prepared a detailed Appeal Submission for presentation to the IRP. We also corresponded with the ICB to reach agreement as to review of additional periods of care.

We represented Clare at the IRP meeting in November 2022 and funding was awarded, backdated to January 2019 up to the date of Geoff’s death in August 2019, which is expected to result in restitution for wrongly paid care fees in the region of over £40,000 plus interest.

In addition, the ICB are now dealing with the retrospective review of the earlier period of care.

If you need help with your relative’s CHC MDT assessment, appeal or retrospective claim, contact our specialist team on 0161 272 5222 or email us at enquiries@farleydwek.com.

*The names have been altered for anonymity.