Case Study: Securing a £87,360 Per Year NHS Continuing Healthcare Personal Health Budget For A Client With Birth Injuries

Summary

How Rachel Burley Stower, Community Care Law consultant solicitor based in our Croydon office, secured a valuable NHS Continuing Healthcare (NHS CHC) care at home package for a man with severe disabilities.

The situation

Keith is 38 years old and lives at home in the Midlands in a property purchased through his personal injury settlement. He lives with his mother who is his main carer and his lay Deputy.

Keith has cerebral palsy, quadriplegia with an over laid hemiplegia of all 4 limbs, a severe learning disability and epilepsy.

Keith’s disabilities were caused at birth and the NHS accepted liability when he was nine.

When Keith was 20, a care package costing £1,400 per week was put in place, paid from his personal injury settlement.

Keith’s mother contacted Rachel because she was concerned that Keith’s settlement would not sustain the long-term cost of his care.

What Martin Searle Solicitors did

Rachel identified that Keith has a primary healthcare need and his care should be funded NHS CHC. The NHS were resistant to assessing Keith and suggested that Keith’s rehabilitation potential had to be explored first. This would involve Keith moving to a residential care setting.

Rachel argued that the National Framework Guidance does not make provision for an NHS CHC assessment to be delayed while rehab is explored and not 38 years after the incident that caused the disability. She pointed out that the reference to rehabilitation applies to people awaiting hospital discharge.

The NHS Clinical Commissioning Group (CCG) backed down and assessed Keith, who was found to have a primary healthcare need. Rachel requested a Personal Health Budget (PHB) but the CCG were resistant.

Rachel threatened judicial review in relation to the CCG’s failure to complete a lawful assessment, offer a PHB and arrange a suitable interim care package.

The result

The CCG agreed a PHB for Keith of £87,360 per year, more than his original care package. The funding has been backdated to the date of assessment. Rachel is now working on a retrospective NHS CHC application for Keith.

If you need expert advice regarding Community Care Law, our Health and Social Care solicitors team can help. Contact us today on 01273 609911, or email info@ms-solicitors.co.uk to find out more.