NHS Continuing Healthcare – ’a matter of interpretation’
Exeter case highlighted healthcare funding issues
The criticism of the process which decides who is eligible for NHS Continuing Healthcare is set to continue unless a less subjective means of assessment is established according to Louise Tribble, a lawyer with Michelmores Solicitors and a specialist in the care sector.
She said: "NHS Continuing Healthcare is a complete package of ongoing care arranged and funded solely by the NHS where an individual's primary need is assessed as health related and not because of social reasons.
"The problem arises because the 'decision support tool' - which scores individual needs using a set of criteria including mobility, continence, behaviour and communication - is subjectively interpreted and can lead to thousands of pensioners every year having to unnecessarily sell their homes or use their life-savings in order to fund long-term care."
Louise Tribble added that the issue first came to the nation's attention in 1999 because of a Court of Appeal judgment involving an Exeter woman, which stated that the eligibility criteria were too restrictive.
"In that particular case, Pamela Coughlan lived in a self contained flat within Mardon House in Exeter because of injuries suffered in a horrific car accident in 1971. The health authority argued that she was not entitled to fully funded NHS care because she only needed general nursing and not specialist nursing.
"The court did not agree, and this case clearly established that where a person's primary need is for health care, and that is why they are placed in nursing home accommodation, the NHS is responsible for the full package of care.
"This case set a relatively low threshold of eligibility for NHS Continuing Healthcare, which was then confirmed in a more recent 2006 case.
"This hasn't stopped the assessment process becoming a postcode lottery, however, so it is important that those denied NHS Continuing Healthcare are made fully aware of the reasons behind the decision affecting them as the process can be challenged."
For further information please contact Louise Tribble on 01392 688688 or by email at louise.tribble@michelmores.com.
Read more about Michelmores' legal services for the elderly
( Last Updated: 18-03-2010 )
