Case studies & success stories

PUPoC Success Story

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Retrospective Review

We were instructed to carry out a retrospective review of a previously unassessed period of care (PUPoC) and consider whether our client was eligible for NHS Continuing Healthcare Funding (CHC). Following a lengthy battle with the NHS Integrated Care Board (ICB), we were successful and CHC was awarded for the period under review.

In order to obtain reimbursement of the care fees paid, we then supplied our client’s documentary proof of payment to the ICB – including invoices and a statement of account from the care home, and bank statements.

The ICB duly responded with their offer letter of reimbursement together with breakdown of their figures and interest calculation. Having forensically checked their figures, we calculated that they had wrongly applied interest – resulting in a much lower offer. Their miscalculation represented a significant shortfall of a startling £17,000. When challenged, the ICB accepted they had made an inadvertent error and re-submitted their calculation for acceptance. Fortunately, our client employed our services because as a result of our intervention, the family is substantially better off.

Whilst we accept that this was a genuine mistake by the ICB, it should not have happened. It does, however,concern us that families representing themselves might not have been able to understand the interest calculation or indeed be astute enough to realise that they were being short-changed (albeit inadvertently), or know how to successfully challenge the ICB’s miscalculation. Without representation, an innocent party could easily have accepted a lower payment without being any the wiser.

We also offer our Restitution Calculation Service – a brand NEW, unique, stand-alone service, to help families who have managed to navigate the CHC process on their own, and to ensure that they receive fair and proper restitution and reimbursement of care fees paid.

"Carla acted as our nurse advocate at a recent DST meeting. We had a two hour preliminary phone discussion a couple of days beforehand and Carla's professionalism and attention to detail was immediately apparent. Her assistance on the day was invaluable as her clear undertanding and cross referencing of the various records meant that she was able pick up on any discrepancies/omissions and ensure that proper consideration was given and that nothing was overlooked or misinterpreted by the assessor. We couldn't have gone though this process without such amazing support. Thank you."

Martin Wallbank

"My sister and I have received absolutely first class professional support, guidance and advice throughout an extended period of time, seeking CHC on behalf of our mother. Every member of the team, with whom we had various communications with, were professional, courteous, and clear. The process is a challenging one and without their guidance, support and expert knowledge we would not have achieved the successful outcome that we did. We cannot recommend them enough."

CHC client

"Without Farley Dwek’s support we wouldn’t have secured the funding. Soon after we presented our case with Farley Dwek we were informed by the NHS that my mother was entitled to the funding after all. It was a huge relief because the size of the care home fees can be a huge worry."

David Newton

"You don’t need any more worry about how to come up with the money at a time when you are trying to cope with the emotion and distress of trying to get the best care possible for loved ones. This needs sorting out and I’m glad Farley Dwek is on my side and helping through the process."

Brian Marshall

"Andrew had a high degree of expertise in this field and was able to offer practical advice on how best to prepare an evidenced based case. He was also able to identify areas where the framework had been incorrectly applied. With this expert knowledge and guidance, we were successful in our appeal and the original recommendation of the DST was overturned. Our mother was awarded full CHC funding, backdated with payments refunded. The best £300 we ever spent!"

Jane

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