Case Studies

Patient circumstances

Mrs ‘D’ from London was still living at home but needed 24 hour care. Her application for NHS funding had previously been declined despite formal assessment recommending full NHS continuing healthcare funding.

Action taken to provide resolution

Following the initial assessment recommendation, an appeal was lodged through the NHS dispute process. The appeal was in pursuit of the full funding amount to deliver her care.

Positive outcome

A further revised assessment through this process resulted in the ward of full funding, also backdated for two years, recouping Mrs ‘D’s’ family almost £120,000 in care costs.

Patient circumstances

An instruction was received from a solicitor acting as legally appointed deputy for Mr ‘S’ from Torquay, who did not have any family. An application made for NHS care funding had been declined.

Action taken to provide resolution

A full audit of Mr ‘S’s’ care home and GP records was carried out. It was determined that eligibility for funding could be proven and his case was duly prepared and presented at an NHS decision panel.

Positive outcome

Mr ‘S’ was awarded his funding, currently and retrospectively, and all of his care fees already paid were refunded to his estate. No further fees were payable ongoing for at least 12 months.

Patient circumstances

Mrs ‘T’ from Bolton had a fall at home and was admitted to hospital as a result. Her only surviving family member lived in London and was unable to undertake a local search for an appropriate care home in person.

Action taken to provide resolution

A hospital visit was carried out to make an assessment of the level of care required for Mrs ‘T’ when she was able to leave the hospital. A suitable, local care home was identified for her and this also facilitated discharge. 

Positive outcome

Mrs ‘T’ was placed in the care home and a follow-up service was organised to carry out regular checks to ensure her care was suitably progressing. In addition, a nil ‘top up’ contribution was negotiated with the care home.