Case Study: Securing a Valuable NHS Continuing Healthcare Award for a Woman with an Acquired Brain Injury and Complex Physical Disabilities

Summary

How Cate Searle, expert Community Care Law solicitor based in our Brighton office, secured an award of NHS Continuing Healthcare (CHC) for a woman with an acquired brain injury and complex physical disabilities, including a considerable lump sum payment and valuable ongoing funding.

The situation

Susan requires around the clock care and supervision due to her challenging behaviour resulting from her acquired brain injury. Susan has autonomic dysreflexia and other significant physical and cognitive health issues. Her support package is very expensive as she needs highly skilled carers and intense therapy input. She has almost 50 care management, risk assessment and behaviour agreement plans in place. Susan was privately funding her care-at-home package from her Personal Injury award.

Susan’s Professional Deputy, Emma, believed that her client’s needs were sufficiently complex and intense such that her support package at home should be publicly funded through NHS Continuing Healthcare.

However, the Clinical Commissioning Group (CCG) resisted Emma’s NHS CHC application for her client at every possible opportunity, so Emma sought Cate’s expert Community Care Law advice and assistance.

What Martin Searle Solicitors did

We represented Emma at an NHS England Independent Review Panel. The CCG continued to argue that Susan was not eligible, however the Panel accepted Cate’s legal arguments that Susan’s healthcare needs were intense and that her support package was complex to manage. Emma had kept very detailed records of her involvement as Susan’s Deputy in maintaining the package of support, and these records and the comprehensive care team notes were accepted by the Panel as key in evidencing Susan’s eligibility for NHS CHC.

The result

Susan’s privately funded support costs of £660,000 were reimbursed for the previous 3 years. Importantly, the CCG accepted a duty to fund Susan’s ongoing care, to the value of £220,000 per annum.

If you are a Professional Deputy looking to access NHS Continuing Healthcare funding for your client, our expert Community Care Law solicitors can help. Contact us on 01273 609911, or email info@ms-solicitors.co.uk.