Case studies & success stories
Retrospective Review Success Story
We helped with
Retrospective Review
This week’s success story concerns a patient who did not trigger for full assessment on the Checklist, but was subsequently found ELIGIBLE for full NHS Continuing Healthcare Funding (CHC) six months prior to that date!
The patient was considered for CHC Funding by her local NHS Clinical Commissioning Group (CCG) by means of a screening Checklist – which did not indicate the need for full assessment. The patient died shortly thereafter. Her family complained to the CCG about the inaccuracy of the Checklist; the CCG agreed to conduct a retrospective review for the last twelve months of life.
Farley Dwek Solicitors were instructed to assist the family with the retrospective review. We obtained copy of the patient’s care and medical records, and prepared a Written Submission in support of the case. Following an initial assessment, the CCG awarded CHC funding but only for the two months prior to the patient’s death.
Farley Dwek appealed the decision of ineligibility for the remaining period and attended a Local Review Panel arranged by the CCG. The Panel upheld the CCG’s decision of ineligibility.
We requested Independent Review of the decision by appeal to NHS England, which set a date for the Panel hearing. One week prior to the hearing, the CCG contacted us to advise it had reconsidered its decision and agreed with us the patient met the criteria for full CHC Funding throughout the period of appeal.
This is a wonderful result for the family and quite a turnaround in the case of someone who supposedly did not even meet the criteria for full assessment!