Information
Today there are over 200,000 people receiving long term care throughout England and Wales and, by recent estimates, over 800,000 sufferers from Alzheimers/Dementia. Very many of these people are funding their own care, paying an average of over £30,000 a year. 45,000 homes are sold in England every year to fund nursing care. However, a large number of them - those whose main need is to receive nursing care - are eligible to have their fees paid by the NHS. More importantly, they are also eligible to reclaim fees which they have paid in the past.
The financial implications of doing this are potentially very serious for the NHS so individual health authorities tend to be rather cautious when assessing claims for payment. Additionally, different authorities have interpreted the criteria for qualification in different ways. This means that claims are by no means clear cut and really do require expert help if there is to be a reasonable chance of success.
Fortunately, at Carehome Claims we have the skills, knowledge and expertise to help you, or a relative, assess whether a claim will be possible and to help you with it every step of the way. Ultimately, this could enable you to claim back many thousands of pounds.
The Coughlan Case
In 1999 there was a landmark ruling when Pam Coughlan took her local health authority to court after they had refused to fund her nursing home fees. She fought their decision and went on to win her case in the Appeal Court.This was such a landmark case that it became known simply as Coughlan.
After this case new guidelines were put into practice within the local Health Authorities to ensure people were assessed more accurately and fairly, but it soon became apparent that this structure was majorly flawed, with criteria for assessing eligibility varying between local health authorities.
The Grogan case
Chronically ill Maureen Grogan also challenged the decision by her local health authority to deny her full funding for her nursing care She suffered from multiple sclerosis and was placed in a nursing home in 2003. She was told she wasn't eligible for full NHS funding and was forced to sell her home to cover the costs of her care.
Even though the Department of Health had drawn up new guidelines in 2001 it was criticised by the Health Services Ombudsman and the Health Select Commitee for being unclear. On 25th January 2006 Mr Justice Charles found that the criteria being used by the Trust was "fatally flawed" and the Judge quashed the decision not to fund Mrs Grogans care.
The Grogan case was by no means a 'one off'. There are thousands of elderly and sick people across England and Wales who may also have been wrongly denied NHS funding for their nursing care.