Social work and end-of-life care

Social work is important in end-of-life care

Archive for the ‘continuing healthcare’ Category

Continuing healthcare judicial reviews: assess very carefully

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I’ve not been looking at continuing healthcare recently – this is the process of assessing people for NHS funding rather than social care funding of care packages, and involves what is now a Clinical Commissioning Group deciding that someone has a difficult to provide-for healthcare need, rather than a social care need. It is particularly relevant to end-of-life care, since many patients will met the criteria.

There are two recent judicial reviews. The Dennison case was a retrospective case, where a relative appealed for belated payments after the death of the patient. The result was partially positive, the reason being that the assessor had not fully completed to assessment; they needed to complete the comments boxes and make a clear assessment of need. Nurses usually do this job, and this tells you that you need to train them well and they have to be very literate and thoughtful about how they complete the forms; the implications, both for the CCG and the relatives, of awarding Continuing Healthcare are such that this is never a routine or tickbox exercise.

Link to the Dennison case.

The Whapples case was about whether the CCG could insist that other alternatives should be looked at.  The answer was ‘yes’. This case was partly about suitable housing, but I find this interesting because my experience is that adult social care departments often insist on a continuing healthcare assessment if they think there’s any prospect of an award, before they will look at a community care assessment.

Link to the Whapples case

Link to a legal commentary (Hill Dickinson)

Link to a Mental Health Care Online report.

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Written by Malcolm Payne

2 October 2014 at 11:48 am

Long-term care needs to be reliable, with funding certainty: not a government priority

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In a useful comment, lawyer Richard Lodge from the solicitors Kingsley Napley comments on compensation claims against the NHS. Someone else has argued that calculating the costs of care through private provision is ramping up the costs, and NHS care should be the main basis for care, but is not accounted for, by law, in the calculations. Lodge points out that most care payments is for the activities of daily life and usually provided by social care, for which the disabled person has to make a contribution. In any case, nowadays and increasingly in the future, it is provided through private care agencies, so the costs are legitimate.

Link to Richard Lodge’s comment.

This is not just a lawyer justifying himself, but reflects a reality which is very little recognised by some people in the NHS and many policy-makers. Long-term care is usually social care, and the NHS with its focus on getting people through an illness, is not the right organisation to be concerned with long-term care. Continuing NHS care is supposed to provide for long-term healthcare needs, but is usually administered very defensively, so you cannot rely on it. Reliable long-term care is a huge commitment, which local authority social care services have to take on without any certainty about funding into the future. And we’re not getting certainty because the government thinks sorting out the economy is more important than reliable long-term care.

Written by Malcolm Payne

9 January 2013 at 10:40 am

New ‘Continuing Healthcare’ framework documents – changes from the old

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1211221Continuing care docHere’s a useful info letter from Mills and Reeve, a law firm. It describes the changes in the recent Department of Health guidance on Continuing Healthcare. This is the funding for people who need homecare – it’s more generous and flexible than social services community care funding, if you are eligible. The ‘National Framework explains the whole thing and tells the professionals (usually nurses) how to do the assessments. Crucial to people who want to fight a decision. Because the order of the new framework has changed, the Mills and Reeve info has a table showing where you can find old topics in new places.

Link to the Mills and Reeve newsletter.

You can download a new Framework document from here.

If you’re interested in getting regular legal newsletters, link to my ‘I find it useful’ listing.

Written by Malcolm Payne

21 December 2012 at 5:05 pm