Time limits to request a review of eligibility decision for NHS CHC

1. Guidance for Strategic Health Authorities and Primary Care Trusts on the time limits for individuals to request a review of an eligibility decision for NHS Continuing Healthcare Funding.

Dated 15 March 2012 - Gateway reference 17393 -
http://www.southofengland.nhs.uk/wp-content/uploads/2012/04/NHS-CHC-Reviews-Guidance-2012.pdf

2. Introduction of Timescales for Reviews of NHS CHC Eligibility Decisions from 1st April 2012
FAQs - Dated March 2012 - http://www.southofengland.nhs.uk/wp-content/uploads/2012/04/NHS-CHC-Reviews-FAQs-2012.pdf

Sorry, guys, I'm afraid I haven't got time to pull out the juicy bits so you'll have to read it yourselves.

The deadlines have been introduced because the responsibility for NHS continuing healthcare is moving from primary care trusts to clinical commissioning groups (CCGs) and Department of Health wants to set clear cut off points for historical cases.

Primary Care Trusts currently have responsibilty for assessment and decision making for NHS continuing healthcare. As from 1 April 2013, this statutory responsibility will transfer to Clinical Commissioning Groups (CCGs); it is therefore considered appropriate to introduce these changes in order that at the point of handover (from PCTs to CCGs) there are clear deadlines set for historical cases requiring assessment of eligibility.

http://www.see.nhs.uk/content.asp?page_id=593&print=on

Red above = my highlighting. Red above = you have been warned. Red above = alert.

Other versions are available.

http://www.mills-reeve.com/files/Publication/5dd35607-b6bb-47e4-8eed-54eab181acde/Presentation/PublicationAttachment/1cd0dd72-d662-4cef-b973-58d615c95782/CHC_eligibility_reviews_briefing_March%202012..pdf

I think this link could be of interest to us, I have made particular note of the "conclusion" This team of Solicitors work mostly for the other side!!

Sheba32

Nice find, Sheba!

The deadline for the abolition of PCTs is also on course for April 2013, with SHAs being demolished sooner.

http://www.camdenlink.info/news/abolition-pcts-shas-etc-nalm

Sorry to be a numpty guys but can you tell if these deadlines/abolition of the SHA`s are going to affect me, if at all?

I am obviously already in the system as you know and my LRP will be 31st August. I am contesting the period 4th Feb 2011 to August 2011. (it`s taken this long to get to this early stage) If/when they turn me down would it be prudent to have a typed letter ready to hand in stating I wish to proceed to LRP? and will I still be able to proceed to IRP if the SHA no longer exists?

wasp

As you said, wasp, you are already in the system. These deadlines are really for people who have not before now put in an application for CHC on behalf of either themselves, or on behalf of their relatives.

You have already told the PCT the period of time you are wanting to 'challenge'. So, unless you have other periods to challenge, you are on safe ground. If you do have 'other periods of time' to challenge, put that in writing soonest to your PCT.

You've used the letters LRP twice in your post, so I take it you mean 'after LRP' move onto IRP.

They are unlikely to turn you down at your LRP meeting .... because they all normally have to go off into a huddle and deliberate ... so it may take a few days for them to tell you that they've turned down your application. So 'always look on the bright side of life' for now.

But, there are no golden rules, so if you take a dated and signed letter with you, and hand it over to them, telling them that you will be move onto the next stage, IRP, it can do you no harm. Or you can just keep it in your pocket, depending on how the 31 Aug meeting goes.

Nobody knows what will happen when the PCTs and SHAs cease to exist, and these newly-fangled CCGs emerge. So your guess is as good as anybody's. Having said that, the CCGs will take over responsibility, so any 'currently-in-the-pipeline' case must go forward into the CCG area. If it doesn't, ask your MP for support and advice, guidance and ..... wisdom. (Do MPs do wisdom????)

Thanks again Kermit. I did mean IRP yes, sorry. I have read so much today my brain hurts (doesn`t take much )

M.P.s do only feigned wisdom. However they do schmoozing very well! (sorry Mrs P&J )

wasp

Hello all, Just spotted this on the web. No mention of this made to me by the assessors I have been dealing with, maybe they thought I had given up!!!!

Welsh Government / Handling retrospective NHS continuing healthcare claims

Last updated 15 August 2012

The Minister for Health & Social Services has agreed the recommendations regarding funding.

Date of decision / Dyddiad y penderfyniad:
30 July 2012

Statement of information / Datganiad gwybodaeth:

Under arrangements set out in WGC 13/2011, Powys (teaching) Health Board is responsible for managing NHS continuing healthcare (CHC) claims received between 1996 and 2010.

It set up a Project Team to manage those 2,511 claims relating to the 2003-2010 period. Welsh Ministers provide £940,000 p.a. for the Project’s work, on the basis all claims are managed by June 2014. Powys recently undertook a modelling analysis of their performance to date. Their subsequent report highlighted a number of issues indicating potential slippage of the agreed timescale. To resolve this, the report proposes additional investment of £1.6 million for the remainder of the Projects lifespan, on top of the existing £940,000 per annum it currently receives.

The Minister for Health and Social Services is invited to read the report and asked to approve contributory funding from the Welsh Government of £0.8 million as part of a total further investment of £1.6 million. This will allow Powys (teaching) Health Board to manage all CHC retrospective claims within the agreed timescale by June 2014.

I have sent an e-mail to the assessors I have been dealing with asking for explanation. Will let you know what they say. The bold text is my accentuation.

Sheba32

A link to the original of sheba32's post - for those who may be involved :

http://wales.gov.uk/publications/accessinfo/drnewhomepage/dr2012/julsep/health/lg1995/?lang=en

I haven't managed to come by WGC 13/2011 that's referred to ..... so how the heck is anyone to connect with the original?

Why not ask your contacts, sheba, to let you know how to find WGC 13/2011 - unless you've already found it, of course, and if you have, can you post a link to it.

Ta nicely!

Will do Kermit
Sheba32