Case studies & success stories

ICB Decision Appeal

Heart hands icon

We helped with

ICB Decision Appeal

This week’s success story concerns a patient who sustained a considerable pressure injury having been left in an unsuitable chair for too long by the nursing home. Staff had accepted his decisions to decline repositioning, notwithstanding Mental Capacity Assessments confirming he was unable to make informed choices about this care due to a severe cognitive impairment.

Despite the fist-sized, necrotic wound having been graded by the Tissue Viability Nurse only days earlier as a category FOUR ulcer, extending to the underlying tendons or bone, the Multi-Disciplinary Team (MDT) assessed only a ‘High’ level of need in the Skin domain. The stated rationale that the wound was “responding to treatment” confirmed a clear misapplication of the descriptors on the Decision Support Tool.

Problems with wound healing were further compounded by severe contractures, lack of sitting balance, lower limb spasticity and spasms.

The Nurse Assessor unilaterally reduced the assessed ‘Severe’ level of need in the Cognition domain to ‘High’ after the MDT, without discussing with the Social Worker, following a review of care plans, ignoring the Mental Capacity Assessments and Deprivation of Liberty Order.

Despite the unequivocal complexity of the patient’s needs, the ICB ratified the recommendation of the MDT that he did not meet the criteria for CHC funding.

Farley Dwek were instructed to appeal the decision on behalf of the family, obtaining detailed records and photographs by the Tissue Viability Nurse which contradicted much of the contents of the nursing home’s inaccurate documentation about the pressure ulcer. Detailed Written Submissions were provided to the NHS Integrated Care Board (ICB) in support of the appeal.

Following a brief Local Resolution Meeting, the ICB overturned the decision of ineligibility within 24-hours, correctly increasing the level of need in both the Skin and Cognition domains to ‘Severe’.

I cannot recommend FARLEY DWEK enough should you find yourself in this unfortunate situation. They ring you when they say they will, they write to you with updates and keep you informed all the way. I'd like to especially thank Ruth Pople and Jonathan Dwek who I regularly spoke to during the process.

Chris Gregg

From first contact with the managing partner Andrew Farley and Ruth Pople, Senior Case Manager , Farley Dwek appeared to be a very well organised Law firm. The staff is very professional and takes all the time to explain sometimes complicated situations.

CHC client

My family and I cannot rate Farley Dwek Solicitors high enough for all their work in helping us with a successful appeal to grant my father CHC in his care home. As soon as I contacted them I felt listened to and supported and our solicitor Debbie was nothing short of incredible. Very knowledgeable in her field, always ready to offer insight and support and quick to respond to queries, we would have been lost without her! If you are looking for some advice and guidance on CHC’s look no further. Recommend without hesitation.

CHC client

Honest, straight-talking, knowledgeable solicitors. I contacted Farley Dwek via their online ‘contact us’ form regarding my father’s eligibility for NHS continuing care. I knew they were experts in the field and I had already paid for and downloaded their excellent guide on the subject. Despite the fact that it became quickly obvious that there was no case for them in this instance, Ruth still gave me close to an hour of her time and was compassionate, extremely knowledgeable and also willing to give me an honest, off-the-cuff appraisal of our situation and chances of receiving funding.

CHC client

What a life saver Farley Dwek were to myself and my Family. From the first point of contact to the final consultation, the whole process was clear and easy to understand. I 100000% recommend this people focus company that have fantastic work ethics and are so very knowledgeable. I’m so grateful for all the support.

CHC client

Get in touch with our team today

Call 0161 272 5222 Email help@farleydwek.com

By submitting this form, you agree to the data handling as stated in our Privacy Policy