Unacceptable Delays in Continuing Healthcare Assessments

Posted on: September 1st, 2014 by Tim Saunders

Elderly woman waitingBeacon are becoming increasingly concerned about the impact that delays in completing continuing healthcare assessments are having on some of the most vulnerable people in our society.

For most people there are three stages of assessment; checklist (screening), full multidisciplinary assessment, and a decision by the Clinical Commissioning Group. The full assessment process should take no longer than 28 days to complete, from checklist referral through to eligibility decision. Although it is common for assessments to exceed these timescales (indeed the overwhelming majority of Decision Support Tools seen by Beacon over the past 10 years have taken between one and four months to complete) in some parts of the country delays have been growing substantially worse in recent years.

Some people who are already settled in a care environment and are therefore classed as ‘non-priority’ are being made to wait over a year for an assessment. The worst we have identified is a gentleman who was screened ‘in’ for a full assessment in August 2012 following a Checklist referral, assessed 14 months later and received a decision letter in December 2013. For this gentleman an assessment which should have lasted a maximum of 28 days took 16 months to complete.Unfortunately we have many other recent examples of people who have been made to wait up to a year or more for their assessment.

Assessment timescales vary enormously depending on where you live in the country and this is having a very real impact on vulnerable older people and their families who are forced to deal with the uncertainty of funding arrangements, pressure from care homes to pay bills and disagreements between the CCGs and Local Authorities over who should pick up funding in the meantime, at what is already an emotionally exhausting stage of their life.

Worse still, people who are made to wait unreasonable lengths of time for their assessment may be forced into selling their home to fund their care, only to discover a year or so down the line that the NHS should have paid all along. Those individuals can and should be retrospectively reimbursed for the cost of their care, but they will not get their homes back.

We are aware that this situation has been partly caused by a ‘closedown’ of requests for assessments of previously unassessed periods of care. The closedown announcement led to 60,000 requests for retrospective assessments nationwide and this demand has greatly increased pressure on already overburdened continuing healthcare departments. The knock-on impact on people who are waiting for a ‘current’ assessment is clear to see.

At Beacon, we strongly recommend that people who are being made to wait unacceptable lengths of time for their assessment contact the continuing healthcare department of their Clinical Commissioning Group at regular intervals to find out where their assessment is in the queue, and insist upon clear and realistic timescales. Those people who are being put under pressure by their Local Authority to sell the family home to fund care in the interim should discuss the possibility of a deferred payment arrangement with the council.

When the assessment does take place it is important that your care needs are assessed as they were at the time of the original referral, using the multidisciplinary team who were most familiar with your needs as they were at the time. You should also tell your coordinating assessor if your needs have significantly changed or worsened in the months since the referral was made.

People who are eligible for continuing healthcare should have their funding backdated to the 29th day after the date on which the original referral was received. Regardless of the delays, people still have the right to be assessed using the processes established in the National Framework for NHS Continuing Healthcare, and it is important that they are not put at a disadvantage simply because of the CCG’s inability to assess them in a timely manner.

To find out how Beacon can support you with a continuing healthcare assessment or appeal, or to tell us about your experiences, contact us on 0345 548 0300.

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