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FAQs

Here are a few questions which we are often asked in relation to NHS Continuing Healthcare Funding. 

Our CCG says my mother does not qualify for NHS Continuing Healthcare, how do I find out if they are correct?

It’s easy, if you contact Care Home Funding Advocates, we will provide a free initial assessment to determine whether you have a reasonable case for funding.

How long does a claim take?

There is no definitive answer to this as every case has many different variables. If you go to the About Us and Our Services  pages this is made clear. Our unique process enables us to move things along in a timely manner. Making things  less stressful, more cost effective. An all-round better solution.

What can I expect to recover or save from my claim?

As with most aspects of this field there is no one simple answer. If you look at the average stay in a care home and the average fees being paid, then the amount that could be reclaimable is over £70,000. It is important to remember that these amounts will vary considerably dependent on the geographical location.
As of October 2016 the average cost of a care home in England stands at £760.00 per week.

 

On successfully claiming back previously paid fees, interest is also applicable. 

 

As far as savings are concerned, if you only manage to obtain funding going forward it means you are free from having to pay out on average £760 per week. The saving is on average over £39,520. Again this can be significantly higher depending on location.

If I appoint you, what will it cost me?

We work on a fee contingent on success – if we are not successful we do not charge anything.
We do ask for a deposit up front, which is deducted from any further costs if successful.

 

This includes the initial assessment to ascertain if you are eligible for NHS Continuing Healthcare. If it is felt you have a case and we are successful then we will work on an agreed percentage of the funds reclaimed.

 

If I do not qualify for funding is there anything I can do to minimise the financial effects on my estate?

There is advice and there are ways of doing this, however it is a very specialist area. Care Home Funding Advocates  can introduce one of the leading independent experts in this field who will be able to advise you..

 

Can protect my assets from any future Local Authority’s means test?

Again, this is also a very specialist area and we can introduce specialists in this field who can advise fully.

 

I am just beginning to realise I have been wrongly denied funding for NHS Continuing Healthcare in the last assessment. How can I put this right?

The first thing to do is contact Care Home Funding Advocates to enable us to determine if you have a viable case. If we feel you have, we will pursue the case with all vigour on your behalf, advocating  the case and supporting the family at every stage.

 

I want to make a claim on behalf of a relative, how do I go about this?

To act on behalf of another person, legal authorisation is needed. This is in the form of Power of Attorney, or an appointment of Deputy by the Court of Protection. You will need to have been appointed as their attorney whilst they still had the mental capacity.

 

If they had lost the mental capacity  then you must apply to the Court of Protection to be made their Deputy.

 

In the first instance you should contact Care Home Funding Advocates to ascertain if you have a viable case for funding.

 

If your relative had or has a viable case and you do not have the relevant authorisation to act, then we can advise on the steps you need to take to obtain it.

I want to make a claim on behalf of someone who has passed away, what do I need to do?

You need to be responsible for managing that person’s estate, either in the form of Executor of the Will and hold the ‘Grant of Probate’ or ‘Letter of Administration’ documents to appoint us to begin any claims process. Before this can happen we will still have to establish if you have a viable case. The first step is to contact Care Home Funding  Advocates

What do you want from me when you start the claim?

After the free initial assessment in which you provide an outline of you history, active medical conditions and subsequent healthcare needs we need to see proof of your identity.  We then require your permission to access all forms of evidence of your situation. This will include medical records (GP and Hospital), care home records and any other we feel relevant.

 

We then require you to provide a factual account of your situation and history. After this our independent medical experts will form opinions on the extent of your healthcare needs and build a solid case for funding for NHS Continuing Healthcare. Depending on the individual this may be for funding going forward or a claim for retrospective fees or both.

I have already started a claim against the CCG but feel I need expert help can you still act for me?

Depending on whether we believe you have a viable case for funding then the answer is yes. However as we have stated every case is different and it may depend on what stage you have reached in the process. The first step is to contact Care Home Funding Advocates and find out.

Is there a time limit on claims for retrospective funding?

There are new Department of Health deadlines for retrospective claims and newly denied claims. These are dealt with in detail in our Deadlines page..

If your medical professionals believe that I do not have a viable case for funding, what other options do I have to ease the financial burden?

The first thing we will outline is what you should do if there is a significant change in your medical conditions. This could lead to a future successful claim. We can also inform you of any help that is available through the state benefits system along with any other sort of care which may be available.

I have never been informed about NHS Continuing Healthcare, funding availability and my rights to access this service. Should I have been informed and who was responsible for doing so?

In the first instance, if the Local Authority (LA) believes someone requires community care services as defined in section 47 of the National Health Service and Community Care Act 1990 they must arrange an assessment. As a result of this assessment if they believe that some of the individual’s healthcare needs can only be legally catered for under the National Health Service Act 2006 a further assessment should be arranged in conjunction with the responsible Primary Care Trust (PCT) now known as Clinical Commissioning Groups (CCG’s) to assess their extent.

 

The extent of these healthcare needs should be assessed under the guidelines of the National Framework for Continuing Healthcare and NHS Funded Nursing Care. The National Framework also states that; ‘assessments, and the consideration of eligibility for, and delivery of, NHS Continuing Healthcare and NHS-funded Nursing Care should be organised so that the person who is undergoing an assessment and their family and/or carers understand the process, and receive advice and information to enable them to participate in informed decisions about their future care’. The NHS should have kept you informed.

I have seen the term Maladministration of the process used, what is it and does it apply to my case?

It is important to remember that this is a process which determines an individual’s access to a free NHS service. The NHS must carry out the administration and delivery of NHS Continuing Healthcare and NHS Funded Nursing Care in a proper, lawful and transparent manner. The National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care was introduced to provide the guidelines so the decision complies with the relevant legislation and the rulings of the relevant case law, especially the Coughlan case.

 

If the NHS failed its duty to comply then they could be considered to have maladministered the delivery of the process.

 

During our review we look for any evidence of this. If we believe there is a case for maladministration, we gather all evidence. We will then formulate a claim for additional compensation.

How does your service differ to other companies and solicitors who offer help in this field?

We believe we offer a unique service which involves meeting the patient and family in situ and compiling a powerful case for the granting of funding.

 

We support and help the family, we are always available in the dark moments. Advocating the case in person at the important assessment meeting is a powerful tool in our armoury. We do not try and influence or overturn decisions by writing letters sat at a desk at the other end of the country.

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