We recently learned about a Multi-Disciplinary Team meeting (MDT) to assess an individual’s eligibility for NHS Continuing Healthcare funding (CHC) which took place in a hospital. Whilst quite permissible, a hospital setting for an assessment is now considered far from ideal.
According to paragraph 109 of the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (revised October 2018), the assessment should now take place in a community setting – ie the place where the individual lives. The Framework indicates that “it is preferable for eligibility for NHS Continuing Healthcare to be considered after discharge from hospital where the person’s ongoing needs are going to be clearer.” Otherwise, such an assessment might not accurately reflect the “individual’s needs whilst they are in an acute services environment…”
But, that is not all. Read on. It gets far worse!
The MDT took place without informing the individual who was actually being assessed – despite the fact that she had mental capacity. Nor did the MDT advise her husband that it was due to take place. They simply told him that they were having “a little meeting”… which, in fact, turned out to be the full MDT itself! So, the MDT went ahead without the individual or a family member being present, and without any opportunity for advocacy support or anyone being able to present their case for CHC funding to the Clinical Commissioning Group. We would like to think that this was a purely an administrative oversight by the CCG rather than a deliberate attempt to exclude the individual and her husband. But either way, it is clearly an abuse of process, and if it happens to you, it should be vigorously challenged and you must appeal immediately.
Our comment: Firstly, a hospital setting is not usually the appropriate venue for such an MDT meeting as the purpose is to assess the person’s health needs in their living environment with access to all relevant (care or nursing) records, nursing assessments, behavioural assessments, current care plans, a 24/48 hour diary indicating needs and interventions, GP information, speech and language therapy (SALT) assessments, falls risk assessments, Waterlow scores, psychiatric nurse assessments etc. etc. but to name a few! The National Framework gives a long list of examples of the types of document one could include as part of the assessment.
If the MDT assessors didn’t even consult with the individual being assessed or her husband, then it is highly likely that they didn’t have access to all relevant records either – especially in a hospital setting – where most of the pertinent care records would not be kept anyway.
If this has happened to you, we strongly recommend appealing any adverse decision if CHC funding is not granted.