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Families urged to ‘know their rights’ as DHSC publishes new CHC guidance

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The Continuing Healthcare Alliance (CHA) is urging UK families to know their rights following the publication of new guidelines that could see “no win, no fee” companies cash in on backdated care claims.

The new guidelines enable Integrated Care Boards (ICBs) to consider eligibility for a past period of NHS continuing healthcare (CHC), even for those who did not apply, but think they are entitled to funding.

The CHA is a group of organisations and charities campaigning to improve CHC in the UK.

The group is made up of organisations including Parkinson’s UK, Dementia UK, Age UK, the Spinal Injuries Association, the Alzheimer’s Society and Marie Curie.

The organisation has contributed to the revised DHSC guidelines on Previously Unassessed Periods of Care (PUPoC).

Laura Cockram, Head of Campaigns at Parkinson’s UK and co-ordinator of the CHA, said: “Most CHC applications are made at an already difficult and emotional time.

“It can be a long, taxing process.

“As an Alliance, we recommend applicants familiarise themselves with their rights both when they start the application, and seek qualified support, where possible.”

Some individuals with long-term complex health needs qualify for free care arranged and funded solely by the NHS.

This CHC can be provided in a variety of settings outside hospital, including a home or care home.

The newly-updated guidelines include:

  • The transfer of responsibility from the applicant to the ICB to gather the relevant care records and documentation.
  • Responsibility for making a direct referral if they are not the correct commissioning body.
  • The introduction of a 12-month timescale to make sure all cases are completed in a timely fashion.

The CHA is now warning people to think carefully before applying for the funding, and to seek advice from one of the organisations in the Alliance, before they make any applications.

After 2012, the NHS received nearly 60,000 new retrospective claims, 51,000 applications (85 per cent) of which were deemed ineligible, and fewer than 600 applications (10 per cent) were approved as being eligible for funding.

Numerous “no win, no fee” claims firms cashed in on vulnerable families.

These companies were ill-informed of the assessment process, mismanaged expectations and encouraged applications regardless of spiralling legal costs, even though they knew only a small percentage would be successful.

In some cases, the assessments took up to 10 years to complete, locking families into “no win, no fee” contracts.

Many were unable to end their claim without paying a fee and were powerless to recover their care records.

Dan Harbour, Managing Director of social enterprise Beacon CHC, said: “We absolutely encourage people to apply for retrospective CHC funding where they believe they have a legitimate case.

“However, it is crucial that individuals are aware of and understand their rights.

“Due to the highly specialised nature of CHC, if you feel that you need advocacy or representation it is vital that you find an organisation with the right expertise in the field to support you.

“Bear in mind that no firm, regardless of credentials or experience, can guarantee a favourable outcome to an application.

“Free information and resources are available to support those who don’t require representation.”

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