Case studies

Kate’s mother Gill was assessed for NHS Continuing Healthcare (CHC) and found not eligible. In the months and years following this assessment, the ICB periodically reviewed Gill’s needs and on each occasion concluded there had been no significant change and that therefore there was no need to re-consider her for CHC funding. With Beacon’s assistance, Kate appealed the original assessment decision and was successful at Independent Review (IR). However, the ICB stated they would only pay reimbursement up until the date of the first review. This constituted just 1 month of funding to be reimbursed. Because each of the ICB’s reviews had ...

With free support from Beacon’s Information & Advice service, Margaret fought against the unlawful practice of families having to pay top-ups for care – and received over £35,000. In January 2012 Margaret’s (not her real name) mother, who had Parkinson’s disease, fractured her hip and was admitted to hospital. In hospital she was assessed as eligible for NHS Continuing Healthcare (CHC) funding, and was discharged to a nursing home. Margaret was told that the Clinical Commissioning Group (now ICB) that paid her mother’s CHC would not meet the full cost of the nursing home fees. The patient/family was told to ‘top up’ ...

With free guidance from our Information & Advice team, Christine highlighted the flaws in the management of her mother’s assessment and recovered more than £11,000 in care funding. Wynne was unable to make decisions for herself, so her daughter, Christine, held Lasting Power of Attorney and was her representative. However, Christine was not informed when a re-assessment of Wynne’s eligibility for continuing healthcare funding was arranged, and it took place without her knowledge. This review concluded that Wynne was no longer eligible for CHC funding, and a letter was sent to her at her care home. Wynne didn’t have the mental capacity to interpret ...

A few years ago Beacon’s caseworkers began supporting a couple whose son had recently suffered a serious road traffic accident, leaving him with multiple life-long physical and mental health needs resulting from his brain injury. Following a significant period of time in hospital during which the young man underwent multiple life-saving operations, he was discharged to a specialist long-term care facility, in receipt of an extensive care package. This care package was initially fully-funded by the NHS who assessed him as having a ‘primary health need’ due to the extent of his intensive and complex care needs. However, following a ...

Mr Johnson is a gentleman in his early sixties with an Acquired Brain Injury. He has been in receipt of NHS Continuing Healthcare funding for 7 years which pays for an extensive care package in his own home, where he lives with his wife who is also his main carer. The cost of the care package is £80,000 per year. At his annual continuing healthcare review Mr Johnson was assessed as no longer eligible despite presenting with healthcare needs that necessitated 24 hour care and constant monitoring during the day, due to the complex interrelation of his cognitive impairment and ...