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The Uk's Healthcare Law Service
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Example Successful Continuing Care Cases – How bad do you need to be?
Summary of patients involved in continuing care disputes
| R
v North and East Devon Health Authority ex p Coughlan Miss Coughlan was grievously injured in a road traffic accident in 1971. She is tetraplegic; doubly incontinent, requiring regular catheterisation; partially paralysed in the respiratory tract, with consequent difficulty in breathing; and subject not only to the attendant problems of immobility but to recurrent headaches caused by an associated neurological condition (para 3 judgement). The
court concluded at para 3: |
| Leeds
Ombudsman Report Case No E62/93-94 January 1994 A man suffered a brain haemorrhage and was admitted to a neuro-surgical ward…He received surgery but did not fully recover. After 20 months in hospital he was in a stable condition but still required full time nursing care. His condition had reached the stage where active treatment was no longer required but that he was still in need of substantial nursing care, which could not be provided at home and which would continue to be needed for the rest of his life (para 22 of report). The importance of this assessment was emphasised in NHS guidance EL(96)8 which (at para 16) criticised continuing care statements which placed an ‘over-reliance on the needs of a patient for a specialist medical supervision in determining eligibility for continuing in –patient care’ and specifically referred to the fact that this was not considered by the ombudsman in the Leeds case as an acceptable basis for withdrawing NHS support. |
| Wigan
and Bolton Health Authority and Bolton Hospitals NHS Trust Case No
E420/00-01106 Mrs N had suffered several strokes, as a result of which she had no speech or comprehension and was unable to swallow, requiring feeding by PEG tube (a tube which allows feeding directly into the stomach). Mrs N was being treated as an in-patient in the Trust’s stroke unit and was discharged to a nursing home (p24, para 1). Health
Services Commissioner concluded (at p32, para 30) |
| Dorset
Health Authority and Dorset Health Care NHS Trust Case No E208/99-00107 Mr X suffered from Alzheimer’s disease and admitted to a nursing home (p11, para 1) and allegedly receiving services very similar to Miss Coughlan’s (p20, para 23). Health
Services Commissioner concluded (at p21, para 26) |
| Berkshire
Health Authority Case No E814/00-01108 Mrs Z, a 90-year-old admitted to a hospital suffering with vascular dementia (p35, para 1) and in need of ‘all help with daily living, except feeding’ and resistant to help and needing supervision if she was to take the medication she needed (p38, para 12). Health
Services Commissioner concluded (at p46, para 39) |
| Birmingham
Health Authority Case No E1626/01-02109 Mrs R, a 90-year-old admitted to hospital following a severe stroke, which had left her immobile, incontinent, and confused (and unlikely that her condition would change) (p49, para 1). Health
Services Commissioner concluded (at p54, para 23) |
| Complaint
against the former Shropshire Health Authority Case No E5/02-03110 Mrs F has Alzheimer’s disease and in June 2000 was assessed by a consultant psychiatrist as needing specialist elderly mentally ill (EMI) care. A nursing assessment in November 2000 noted that she required full assistance with all her personal tasks including washing, dressing, feeding and toileting. She was also doubly incontinent, was dependent upon others for her safety, and could only mobilise with assistance. The Ombudsman was advised by her independent clinical assessor that Mrs F required significant nursing care and it was debatable whether that could properly be regarded as merely incidental or ancillary to the accommodation which Mrs F also needed. The Ombudsman upheld the complaint. |
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