Keith is 38 years old and lives at home 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.
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 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.