Appeal for fully funded NHS care (General)

Member Name: poppyash

Product:	General
Date:	15/07/09 (21 review reads)
Rating:

Advantages: You get to point over your point of view and question theirs

Disadvantages: Takes time

I have just successful won an appeal for fully funded NHS health care for my mum who unfortunately, has vascular dementia. It has been a long and stressful experience but at last I feel justice has now been done. I'm not going to bore you with the dramas that unfolded over the last year other than to quickly say that mum had a series of falls which made her non - weight bearing for six weeks. Because of the dementia she either didn't understand or forgot and kept trying to get up. She therefore needed constant supervision and the residential home she was in at the time felt they could not cope with her any more. We were advised that she needed to go into an EMI Nursing Unit and mum was assessed.

The assessment consisted of all the professionals concerned getting together and giving a report on the following areas:-
Behaviour
Cognitive Impairment
Communication
Mobility
Nutrition
Continence
Skin
Breathing
Drug Therapies
Psychological/Emotional needs
Seizures/Altered states of consciousness.

At first mum was turned down for full funding and so I said I was going to appeal. It was then I got a list of the criteria and how mum had been assessed. I knew that the psychologist had only spent 10 minutes with mum one Saturday morning, as a nurse had told me at the hospital when we visited later that day. I found that his report was contradictory which made me want to find out more about the other areas. I contacted the Alzheimer's Society, who were very helpful and offered a lot of encouragement in my appeal. I knew that mum had to be marked 'severe' in at least 2 of the above criteria.

So I wrote a letter of appeal going through each section of the criteria writing down my views and experiences and sent it back to the authorities. I was then invited to attend an informal meeting to basically go through my letter and to air my views. The meeting was very friendly and I didn't feel intimidated at all although I was dreading it beforehand. It was agreed at that meeting that they would continue to pay for mum for a further 6 weeks and then reconvene. After 6 weeks I didn't here anything, although I do know that mum was visited on a number of occasions by various medical professionals. After 12 weeks I was invited to attend a meeting at mum's nursing home, as one of my complaints was that the people making the final decisions regarding mum had never actual met her. The meeting lasted 3 hours and was quite demanding. I felt I had to justify and question every point made but I wasn't going to be fobbed off. At the end of the meeting we all went to see mum. This I felt was the turning point as everyone could relate to what I was saying. I also told them that I would continue to appeal until I got full funding.

Well it all been worth it. I therefore urge anyone facing the cost of care even though the government are now looking into it, to appeal and appeal, its hard work and very demanding, but if you don't ask you don't get. Ask for a copy of the eligibility criteria and who and who isn't eligible for free care. Don't be put off if you are told that the care needs are social care - argue your case. Care fees can cost anything from £450 - £1,500 a week I.e. A WEEK that is a huge financial commitment.

My mum worked all her life and saved for her retirement why should she have to pay over someone who has not contributed a penny!

Summary: Worth the time and energy if you win.