Joe’s Story

We were instructed by ‘Joe’s’ family in relation his application for NHS Continuing Healthcare Funding (CHC).

Following a positive Checklist assessment ‘Joe’ (not his real name) was referred by his local NHS Integrated Care Board (ICB) to a Multi-Disciplinary Team meeting (MDT) to carry out a full assessment of his eligibility for CHC Funding. Joe was assessed at the MDT by way of a Decision Support Tool and determined that he did not meet the criteria for CHC Funding. Instead, he was eligible for Funded Nursing Care – a much lower fixed weekly sum paid by the ICB as a contribution towards his nursing care costs.

Farley Dwek Solicitors were instructed by the family to appeal the negative MDT decision. Following records collation, the ICB provided us with their Needs Portrayal Document (NPD) for comment, consisting of some 77 pages. However, from a forensic review of the relevant nursing home and medical records, we concluded that there was a significant amount of missing entries across the 12 Care Domains, which if included, would paint an entirely different picture of needs and support Joe’s application for CHC Funding. In reply, we lodged our detailed Written Appeal submissions document, amounting to 148 pages of fine detail, including a detailed analysis of the 4 Key Characteristics.

The ICB reviewed their initial poor NPD, and taking on board our comments from our Appeal Submissions, sent a significantly improved and revised version of the NPD for consideration – together with an apology. The revised NPD was approved and sent to the appeal panel for consideration.

We are delighted that Joe was found ultimately found eligible for CHC and was awarded funding retrospectively for the appeal period under consideration. The sums to be reimbursed are anticipated to be significant.

Here’s what our client said:

“From the moment I contacted Farley Dwek and spoke to Andrew Farley up until the successful outcome of my father’s CHC funding appeal, this company have been everything we had hoped for and more.

“Having their own nurse to carry out the assessment really gave us confidence from the start. We feel that the nurse, Diane Jenkins, did a thorough, in-depth and accurate assessment of my health father’s needs.

“Debbie Payton, Senior Case Manager/ Legal Advisor has worked tirelessly throughout the process to ensure the case was represented in an accurate, professional and timely way. Debbie’s communication has been excellent. She has kept us fully informed throughout the process and has always responded very promptly to any questions and queries with a warm, friendly manner.

“This company are clear that they will only take the case on if they believe they will win so they are not in it just to take your money. If the situation changes as information comes to light, they will let you know. I really feel that Debbie cared about getting the right outcome for my father and for us. She did everything she promised to do along the way and we cannot speak highly enough of her.

“We would thoroughly recommend Farley Dwek as an organisation and Debbie Payton in particular. We feel that all that she has achieved on behalf of my father is worth every penny and we believe we could not have got this outcome without her. We cannot thank Debbie enough.” – Rachel W.