Top Tips For Professional Deputies On Retaining Your Clients’ NHS CHC Funding Awards

1. Preparation is critical. Most CHC reviews are undertaken annually. Two or three months before that date, look at your client’s care records, care plans and risk assessments. Do they capture the needs that were described in the last DST, when your client was found eligible? If not, is this because your client’s needs have genuinely changed, or because the content and detail of the care records is inadequate? Talk to the case manager, carers or care home manager about improving the quality, content and relevance of the records. Bland, generic records will not evidence NHS CHC eligibility.
2. If your client has relatives or friends who are involved with their day to day lives, ask the family to keep a diary of relevant healthcare issues and challenges in the weeks running up to the review and use this as evidence.
3. Check through your own file notes and email correspondence. Have particular healthcare issues or challenges been reported to you, or to your client’s Case Manager?
4. At the review or in correspondence, avoid the temptation to argue for eligibility on the basis of your client’s diagnosis / diagnoses. CHC eligibility is NOT based on diagnosis nor specific medical conditions. Likewise, don’t argue on the basis of your client’s advanced age and frailty.
5. Avoid basing your case on your client’s historic healthcare needs. The review deals with your client’s current needs and may look only at a snapshot of the 2, 3 or 4 weeks running up to the meeting.
6. Don’t simply assert that “nothing has changed” and that your client has not “got any better” than she was when first or most recently awarded CHC. It is rarely accurate to say that there has been no change in a CHC context. Even subtle changes can tip the balance between a healthcare and a social care need.
7. Concentrate on evidencing at least one of the four key indicators in your client’s healthcare needs: nature, complexity, intensity, or unpredictability. Eligibility for NHS CHC using the Decision Support Tool is about much more than the “scores on the doors”.
8. At the review meeting, don’t be drawn in to discussing every domain in great detail. When you get to a domain that is not in dispute, try to move the Assessor along by confirming you agree with the score. This leaves more time to get your points across on the contentious domains.
9. With any domain that may be disputed, focus on the wording that is in the descriptor for the score that you think applies. Have a blank DST open in front of you so that you can quote from it, if necessary. Break the wording in the descriptor down in order to give examples. Highlight the key words and give as many examples as you can, to stop the Assessor pushing the score down.
10. No matter how much your client’s family ask you to, don’t compare your client’s needs to those of Pamela Coughlan, concluding that as your client’s needs are greater, under the law your client must qualify for CHC. Tell your client’s family this is a common argument which fails to understand the relevant aspects of the Coughlan judgment.

If you need expert advice on retaining your clients’ NHS CHC funding awards, our Health and Social Care solicitors can help. Contact us today on 01273 609911, or email info@ms-solicitors.co.uk to find out more.