Problems getting NHS Continuing care Funding

Problems getting NHS Continuing care Funding
The person you're looking after may have a continuing healthcare assessment to consider whether their care needs are so great that they should be met free of charge by the NHS. The assessment will look at the type and level of their healthcare needs. Their needs will be looked at in light of a 'national framework': this is government guidance for those carrying out the assessment.

NHS continuing healthcare should be available for people whose need for care is mainly health-related. Services provided by the NHS as continuing healthcare are free of charge. This is different to care services provided by social services, where the person receiving the care services may have to pay a charge.
You and the person you're looking after may need to know how to complain or take further action in the following situations:
• If NHS continuing healthcare is agreed but you are not satisfied with the type or location of NHS care offered.
• If you're not satisfied with the way the continuing healthcare assessment was carried out.
• If the outcome of the assessment was to refuse NHS continuing healthcare.
• If you think NHS continuing healthcare should have been awarded for a past period.
Steps to take
If you're not satisfied with the type or location of NHS care, you can use the normal NHS complaints procedure. This involves making your complaint to the NHS professionals involved in making the decision to see if it can be resolved. This is known as 'local resolution'. You can ask to be put in touch with your local Patient Advice and Liaison Service (PALS). They can tell you about the Independent Complaints and Advocacy Service (ICAS) that could give you support when making the complaint. See External links.
Always try to resolve your complaint locally first, as this is likely to be the quickest way. However, complaints about the NHS that are not resolved at the local resolution stage could be referred directly to the Health Service Ombudsman.
If you're not satisfied with the way the NHS continuing healthcare assessment was carried out or the outcome of the assessment, make your complaint to the NHS professionals involved in making the decision. Following that, you could ask for a review by your regional strategic health authority (SHA). It will set up an independent review panel to consider the case and make recommendations to your local primary care trust (PCT).
The panel will consider whether the PCT has correctly applied the guidance in the national framework when making their decision.
You may find it very useful to get support from your own medical practitioners or from disability organisations that have particular expertise in the health problems of the person you're looking after.
At this stage, you should be offered the support of an advocate if you need one, to help you through the process.
While the review process is underway, the PCT must continue to fund any existing care it's providing for the person you're looking after.
Following the decision of the independent review panel, you may be able to have the case looked at by the Care Quality Commission or Ombudsman (as above).
NHS continuing healthcare between April 2004 and October 2007
There may still be exceptional circumstances for challenging about continuing care before this period and if you are unsure, you should get specialist legal advice. The Health Service Ombudsman has advised PCTs that they should pay the interest on outstanding payments for continuing care and that they should consider compensation payments where appropriate.
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