Case Study: Securing a Much Improved NHS Continuing Healthcare Care Package from the CCG
Summary
How Rachel Burley-Stower, Community Care Law lawyer based in our Brighton office, secured a better package of care from the NHS Clinical Commissioning Group (NHS CCG).
The situation
Jane, a severely disabled young woman based in South Wales, suffers from paraplegia caused by a spinal injury. A few years after this injury, Jane’s disability needs became more complex due to severe burns following a fire at a Social Services day center.
Jane had a Social Services care package in place for many years. In 2016, Social Services suggested that she may be eligible for NHS Continuing Healthcare (NHS CHC). This was preferable because she would no longer need to pay anything towards the cost of her care package. Jane was still expecting to receive compensation for the injuries suffered in the fire and did not want to spend all of this money on her care and support needs.
Jane agreed to a CHC assessment and was found to be eligible for NHS CHC. Social Services followed the correct procedure and withdrew their care package. However, Jane faced difficulties because the CCG had not put an alternative package in place.
Jane rejected the CCG’s care package proposals because they were very different to the care that she had become used to. She felt that the new CCG proposals would not meet her needs. Jane and her family were desperate to reach a solution as her relatives were now covering a 24-hour care rota on top of their personal and work commitments.
What Martin Searle Solicitors did
The personal injury solicitor who was helping Jane to recover compensation referred her to Community Care Law solicitor, Rachel Burley-Stower, for urgent advice. Rachel went through the CCG assessment and care planning paperwork, noting that both were inaccurate and there were critical omissions about Jane’s care needs. In Rachel’s view, the CCG’s proposed care plan was so inadequate as to be unlawful.
Rachel sent an urgent Letter Before Claim referring the CCG to their duties and obligations under the NHS National Framework, the NHS (Direct Payments) Regulations, and Human Rights legislation.
The result
Three days after receiving the Letter Before Claim, the CCG proposed a more suitable package of care which met her needs. This ensured that Jane received round the clock support from two carers.
Jane was able to use her NHS Personal Health Budget to pay the care agency who had previously supported her and knew how to meet her complex healthcare needs.
Jane was overjoyed as her health and well-being had been at risk without a full package of care in place. And of course, her family were relieved as they were at breaking point, attempting to juggle their many responsibilities.
If you need expert Community Care Law advice on NHS CHC, or Planning and Paying for Care contact us on 01273 609911, or email info@ms-solicitors.co.uk.
