Clinical Review Service
Often, even with the information you have provided about your relative’s care requirements, it can still be difficult for us to determine whether your relative may be eligible for funding or not.
In these circumstances we may offer to undertake our Clinical Review Service.
If you proceed with our Clinical Review Service, we will send one of our experienced specialist nurses to meet both you and your relative to carry out an independent assessment of their care needs, face to face.
Following the assessment meeting, our nurse will produce a detailed report which we will send to you setting out our nurse’s assessment of you relative’s care needs. This report follows the same format as the Decision Support Tool (DST) used by the NHS in determining a patient’s eligibility for NHS Continuing Healthcare Funding.
The report will help you to understand whether in our view there is any realistic prospect of arguing that your relative should potentially qualify for NHS Continuing Healthcare Funding.
If our nurse’s report concludes that your relative may not qualify for funding at the moment, you will be able to use the report as a baseline and for comparison purposes, when monitoring important changes in your relative’s condition, in case they meet the funding criteria at any future re-assessment. Furthermore, the report will also give you the reassurance of knowing that the matter has been assessed objectively by a skilled nurse who has a wealth of experience in this specialised field.
If, following the assessment, we believe that your relative could potentially qualify for NHS Continuing Healthcare Funding, we can offer you further services to assist and guide you through the process of applying for the funding. Or, you can use the report to help you to apply for funding yourself.
Our Clinical Review Service is provided on a fixed cost basis, and can also be used prior to considering whether to appeal a decision where (a) funding has been rejected, or (b) existing funding is withdrawn.
Mrs. P contacted us for help with her mothers NHS Continuing Healthcare Funding Assessment. She felt that her mother should receive funding and had organized a Checklist Assessment date with her mothers CCG, but having read our Free Guides and considered the process, she felt that she needed support.
We assessed her mother’s condition and agreed that we felt she would qualify for funding. One of our senior nurses arranged to attend the Assessment as her advocate.The NHS Assessor started the meeting by saying that on her initial assessment, she felt that Mrs. P’s mother didn’t score highly in any of the care domains and appeared to have a stable condition requiring routine care.