NHS continuing healthcare is professional care for the physical or mental health needs of adults (over 18) with a serious, long-term disability, injury or illness. Care can be arranged and funded by the NHS and is free of charge to the person receiving the care.

A person's eligibility to have their nursing fees paid for by the NHS is currently assessed by the local Primary Care Trust (PCT). A national framework was introduced in 2007 to provide guidance to the individual PCTs regarding the eligibility criteria and to ensure that consistent decisions were made across the country. However, despite the introduction of the national framework, the individual interpretation is by the assessors and the local PCT which means there is still huge disparity across the country regarding who is considered as being eligible for NHS Continuing Care.

Continuing healthcare can be provided by the NHS in any setting, including a care home, hospice, hospital or the home of you or the person you look after.

Historically there have been inconsistencies in the assessment for many cases, as a result of these many people have been incorrectly charged for care that should have been funded by the NHS. We specialise in the investigation of such cases and make an independent assessment of the circumstances. If we feel that funding should have been provided but has not, we work to recover the money you have been charged.

There have been two landmark cases that have set a precedent to the legal position for care home charges. As a result of these two cases and the legal precedent they have helped to set, we are able to pursue a legal approach to help you with the recovery of fees that you may have unfairly been made to pay.

Pam Coughlan took her local health authority to court after they had refused to pay for her nursing home costs. In 1999 she fought their decision not to fund her fees and won creating a landmark ruling in the process.

Maureen Grogan was chronically ill and also had to challenge the decision made by her local health authority who denied her full funding for her nursing care. She was suffering from multiple sclerosis and had been placed in the care of a nursing home in 2003. The NHS decided not to pay her fees and as a result she was forced to sell her home to cover the costs of her care.

New guidelines for NHS funding had been drawn up in 2001 - criticised by both the Health Services Obudsman and the Health Select Committee as being unclear. The Hon. Mr Justice Charles of the High Court found that the criteria being used by Mrs. Grogan’s trust was “fatally flawed” and the judge overruled the decision not to fund Mrs. Grogan's care.

These cases are all too common and there are thousands of people across the UK who may also have been unlawfully denied NHS funding for their care. If you feel that you or a loved one have been incorrectly charged for care, we urge you to make the first step in pursuing a refund of your money.

 

To talk with one of our team call
0800 009 6999

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