When our client’s husband developed advanced Alzheimer’s disease, his care needs increased significantly. Initially admitted to a care home for respite support, the progression of his condition meant that residential care soon became a permanent necessity.
Concerned about the ongoing cost of care and unsure whether NHS Continuing Healthcare (CHC) funding should be available, the family approached Compass CHC for support.
We guided the family through our Investigation Service before providing advocacy at both the Checklist assessment and subsequent Decision Support Tool (DST) meeting. Following the assessment process, the Integrated Care Board (ICB) agreed the individual met the eligibility criteria for NHS Continuing Healthcare funding, giving the family financial certainty and reassurance that future care needs could be met.
How Compass CHC supported the family
Our role was to ensure that the full extent of the individual’s health needs was properly understood, evidenced and considered throughout the assessment process.
Working closely with the family and healthcare professionals, our Advocate analysed the available records, identified key evidence and ensured that this information was clearly presented during the assessment. Particular attention was given to demonstrating how the individual’s needs interacted across multiple care domains and the impact this had on the overall management of his care.
The evidence showed significant cognitive impairment alongside complex behavioural, psychological and medication-related needs. His care frequently required the involvement of multiple trained carers at the same time, with a high level of supervision, monitoring and intervention needed throughout the day.
As a result, the ICB accepted that the nature, complexity, intensity and unpredictability of the individual’s needs indicated the presence of a primary health need, making him eligible for NHS Continuing Healthcare funding.
The outcome
The successful outcome means that the family no longer faces the financial burden of funding ongoing care home fees themselves.
Perhaps more importantly, it has provided reassurance and peace of mind at an incredibly challenging time. Rather than worrying about the cost of care, our client can now focus on spending valuable time with her husband, knowing that his current and future care needs are appropriately supported.
As his condition progresses, the funding also provides greater certainty that increasing care requirements, such as one-to-one care, can be met without creating additional financial pressure for the family.
Ewa Krzyszkowska, Advocacy Director, Compass CHC said:
“This case highlights the importance of ensuring that an individual’s needs are fully evidenced and accurately presented throughout the Continuing Healthcare assessment process. By helping the ICB understand the true complexity of the individual’s care needs, we were able to secure the funding that will support him moving forward.”
Key outcomes
- Supported the family from initial case investigation through to specialist advocacy at the Checklist and DST stages
- Ensured all relevant evidence was effectively presented and considered during the assessment process
- Demonstrated that the individual’s needs met the criteria for a primary health need
- Secured NHS Continuing Healthcare funding following the DST assessment
- Reduced the family’s financial burden and provided greater certainty for the future
- Enabled the family to focus on their loved one’s wellbeing rather than the cost of care.
Learn more: What is a primary health need?
Unsure if you or a loved one qualifies?
If you think you or a loved one may be eligible for CHC funding, don’t delay. We’re here to guide you through every step.
Submit an enquiry to get started.
