Re: Mr “TD”

Mr TD’s family contacted us in early 2008 when Mr TD was in hospital having to undergo a blood transfusion every three to four weeks.

He was bedridden since contracting cellulitis in October 2007. Since admission to hospital, he became incontinent and had a long term catheter in place and was also on a drip for hydration which, because of problems with veins in his hands, he then had to have through his stomach. Mr TD regularly needed oxygen as his stats were unstable and he battled pneumonia in November and again in December. Previously, he had a heart attack some 12 years previously and two strokes, the last of which left him with a form of epilepsy for which he took Epilim. Mr TD’s blood disorder was of the type that could turn to leukaemia and when his blood pressure dropped, he was very prone to infection. On top of this, he also contracted MRSA shortly after entering hospital.

In October 2007, Mr TD was assessed by the Local PCT as ineligible for NHS continuing care funding but eligible for 24-hour nursing care. The family did not agree and appealed the decision. Nursing staff kept insisting Mr TD was “stable” when it was clear to the family he was not and there was enormous pressure to have him discharged from hospital. The family were particularly concerned that Mr TD’s blood pressure could drop very suddenly causing an immediate need for transfusions which he would only be able to obtain in hospital.

The family resolved to fight the ineligibility decision “every step of the way”.

After persevering, in May 2008 the PCT decided Mr TD’s primary need for care was a health need and granted fully funded NHS care.

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Re: Application for Continuing NHS Care Funding – Mrs MK

Mrs MK was admitted to a care home in 2004, suffering with dementia and associated problems. Her health deteriorated and she became doubly incontinent and developed deep vein thrombosis and an ulcer which became infected with MRSA. She subsequently had several falls, injuring her eye and received a cut to her head.

Initially, the local PCT assessed Mrs MK as high band Registered Nursing Care Contribution but maintained that her primary need for care was not a health need and, therefore, she was not eligible for continuing NHS care funding.

The family were not prepared to let the matter rest and, armed with an Enduring Power of Attorney, Mrs MK’s daughter instructed Robert Campbell & Company to pursue an application for continuing NHS care funding.

In June 2008, the local PCT confirmed that, having conducted a multidisciplinary assessment under the National Framework for NHS Continuing Healthcare and NHS funded Nursing Care guidance, Mrs King did at that point qualify for NHS Continuing Care funding on the basis that her primary need for care was a health need.

The issue that now arises is whether the family consider Mrs MK’s primary health need arose earlier than June 2008 as the care fees expended since admission to the care home in 2004 are approximately £120,000 and, if the primary need for care arose earlier, then an application for retrospective continuing care funding will be pursued. Any such claim would involve a claim for interest and a head of damage relating to the forced sale of Mrs MK’s house to pay for care fees.

July 2008

Note
Since dictating this it has been decided to pursue a retrospective claim for restitution of fees in the order of £120,000.

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Re: ‘MP’

Extract from excellent letter of initial instruction:

“Margaret’s primary need is obviously a health need. If she did not have dementia she would still be able to look after herself in her own home, doing her own cooking and cleaning and able to go shopping. She was perfectly independent and able to do all these things until the early months of last year (2007) and in fact she only stopped going to her hairdresser around April 2007.

Margaret failed a mini-memory state examination (score nil) at the end of March 2007. It was about this time that she started ‘seeing things’ such as imaginary visitors, people hiding in her kitchen and people sleeping on her couch but it did not seem to bother her overmuch.

The dementia seemed to progress very quickly. I took her to see her doctor in January 2007 because she had been incontinent at Christmas; she was bright and quite coherent but was developing memory problems. I arranged for carers to help her at the end of February, although she was opposed to the idea and carried on doing her own shopping, cleaning etc. She was until the middle of last year capable of independent living and in fact was happily living alone with carers visiting and using Meals on Wheels until her fall on 21 January this year.

There was no injury but she was admitted to hospital because she was dehydrated and also had a minor urinary tract infection. Shortly after being admitted she caught a hospital borne noro virus infection which seriously affected her with diarrhoea vomiting etc. She became (and remains) doubly incontinent, as her confusion increased rapidly. She also lost considerable weight. During the two months she was in hospital she lost 9.9 kg around 20% of her body weight (she continues to lose weight and is now down to 38.6 kg).

After the infection subsided she had various examinations and was seen by specialists including the hospital’s psychiatric nurse. She was rejected for rehabilitation or physiotherapy as she was unable to understand or follow instructions. Drips to rehydrate her were tried but abandoned as she pulled out the cannulae. She also pulled out indwelling urinary catheters. Prior to discharge she had a FACE assessment which describes her need for 24 hour care as critical.

While being considered for discharge the ‘NHS Continuing Healthcare Needs Checklist’ indicated that a full health needs assessment (DST) was required and this was duly carried out by the hospital multi-disciplinary team.

This has two ‘severe’ and five ‘high’ scores which according to the DST Guidelines requires ‘clear recommendation of eligibility to NHS Continuing Healthcare’ unless there are exceptional circumstances.

This assessment was fully discussed with my daughter and me before being signed off by the discharge co-ordinator. She pointed out that the recommendation was for fully funded care but it would need to be verified by the PCT.

Incidentally at the end of the DST is a statement that if there are delays the Panel may request up to date information. There is no mention of carrying out a further full assessment.

Around 10-11 March we heard that Margaret had been declined for fully funded care and received the material from the PCT on 25 March.”

After a battle, in June 2008 Margaret was awarded NHS Continuing Care funding.

Maurice Trimmer
June 2008

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I am attorney for my father who was admitted to a nursing home early in 2005.

At that time the local Primary Care Trust had conducted an assessment and concluded that my father did not qualify for continuing NHS care and instead assessed his registered nursing care contribution at the medium band.

Given my father’s condition I found this really quite extraordinary and in mid 2007 decided to obtain expert help in order to dispute this assessment. Having been recommended to specialist healthcare solicitors Robert Campbell of Robert Campbell and Company I passed over the papers and asked Robert to pursue the matter for us.

Robert initially wrote to the Trust demanding a fresh multi-disciplinary assessment be conducted and, after obtaining the medical records, obtained the report of an expert consultant geriatrician in support of the claim. He was clearly of the view that my father’s primary need for care was a health need, therefore, that he should be entitled to a fully funded NHS continuing care package. With Robert’s help we appealed this decision and were very pleased to hear, at the beginning of March, that continuing NHS health care was awarded from 1 October 2007 and we are now instructing Robert to pursue a claim for restitution for the period prior to this.

The family are most grateful to Robert Campbell for his help in this matter and there is no doubt in our minds that his knowledge, expertise and tenacity in this minefield of NHS law and practice enabled us to win the day. We have no hesitation in recommending Robert’s services to others in similar positions and hope that our success will give encouragement in what, to the uninitiated, is a quite daunting process. Whilst more that happy to provide this case history and testimonial, I wish to remain anonymous for personal reasons.

(Anon)
March 2008

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CASE HISTORY

Our mother went into a nursing home in February 2007 but, although she was very poorly and required a great deal of health care, the local Primary Care Trust refused to fund her placement. We were unhappy about this as we had read that, where someone needed care because of their health, this should be free on the NHS just as though they were in hospital.

We felt very strongly about this and decided to find a specialist lawyer who could represent mum. Fortunately we were introduced to Robert Campbell of Robert Campbell & Company, a firm of solicitors specialising in healthcare law and particularly Continuing Care claims.

Having conducted an initial assessment without charge Robert took over the case on his firm’s special fixed fee scheme and we were delighted when in August 2007 the Trust finally confirmed mum’s eligibility for a fully funded NHS Continuing Care package.

Sadly mum passed away but, although the Trust has refunded us £11000 paid in care home fees, we have asked Robert to pursue a claim to recover the £6,500 paid out in home care fees prior to mum’s admission to the care home as we believe mum was eligible right from the day she required care.

We are most grateful for Robert’s help and support. Very few solicitors know of this area of law which is complex and requires specialist input. We would have no hesitation in recommending Robert Campbell & Company’ services to anyone else in a similar position to ourselves.

Allan and Valerie Davies, York
September 2007

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