jonsmum wrote:After being told in the DST meeting last month that they had decided that my mum should have been funded since October 2010 (although we were told that it was a borderline decision), I recieved a letter yesterday stating that the panel had decided that she didn't meet the criteria and was not eligible for CHC.

So disappointed!

We will carry on with the appeal process but had built our hopes up.

Very sorry to hear your story - bad news indeed.

Next time you will realise that the DST has no authority to make a decision - it's the MDT that does that.

However, it sounds as if the DST members gave appropriate levels - i.e. at least 2 severe's? You must request copies of the hand-written notes from the DST, as well as all other notes / assessments of course. The hand-written notes may (I say 'may') show some alterations / scribbling out etc.

Our story has similar elements: both Social Worker and CHC nurses stated at a subsequent DST meeting that we should have been given funding (they had no authority to say that but they did!) - but this was denied when we threw it in their faces at a later date.

Also, the copy of the DST hand-written notes that we received appeared to be hand-written notes taken down from the typed-up copy - but of course this could not be proved.

So request the notes speedily.

jonsmum

Maryjo is correct, demand to see access copies of the whole rational, especialy the documents (Medical care/nursing home Records) that they have based their decision upon Akka the hand cherry picked records, then compare those records with the ones that you aready have

But appeal against their decision A.S.A.P, btw, 2 severs Equals qualification for FF/CC Dont let them off the hook,

Good Luck

Mick

Apologies - my error.

I should have saaid 'e.g.' not 'i.e.' I did not mean to imply that jonsmum had got 2 severe's - it could have been 1 priority. Anything else and I doubt they would have expressed an opinion. If they did - shame on them, ignorant so-and-so's.
maryjo

Am I correct in inferring that the MDT was recommending to the panel that she met the criteria?

jonsmum wrote:Yes! we were told that it was borderline and the family and the nurses were asked to leave the room for while. When we returned we were told that they had decided that my mum should have been granted full CHC in October 2010. We were told that the panel could overturn this decision but I really thought that they had to follow the decision of the DST unless there were exceptional circumstances.

Jonsmum, sorry to read of all this.

The MDT recommendation is 'supposed' to be accepted by the PCT unless there are exceptional circumstances. So you should ask for full rationale and full details of their reasons for overturning that recommendation, and especially for details of the exceptional circumstances, in writing. (Forgive me if you've already got full reasons from the PCT for overturning the MDT's recommendation.)

Send a carefully worded letter a.s.a.p., saying that you will be appealing the decision and also the fact that PCT overturned the recommendation of the MDT. Ask for a copy of 'absolutely everything' they have on file, including emails, notes of phone calls between them all, and for the full minutes of the panel's deliberations.

NF 2009 (revised) - para 80: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103161.pdf

"Many PCTs use a panel to ensure consistency and quality of decision making. However, a panel should not fulfil a gate-keeping function, and nor should it be used as a financial monitor. Only in exceptional circumstances, and for clearly articulated reasons, should the multidisciplinary team’s recommendation not be followed. A decision not to accept the recommendation should never be made by one person acting unilaterally."

Invite the PCT to provide fully and clearly articulated reasons for not following the MDT's recommendation.

If you need anything more to quote in your letter, come back and we'll come up with precise references for you.

Good luck - go for it!

VM

jonsmum wrote:Thank you for all the responses! My mum was scored 1 severe, 4 high, 3 moderate, 2 low and 2 no needs. One of the highs (psychologcal and emotional) was scored a moderate by the PCT.

The wording to be aware of is as follows:

A clear recommendation of eligibility to NHS Continuing Healthcare would be expected in each of the following circumstances:
A level of priority in any ....
A total of two or more incidents of identified severe needs across all domains.

If there is
One domain recorded as severe, together with needs in a number of other domains or
A number of domains with high and/or moderate needs
this may well also indicate a primary health need. In these cases, the overall need, the interaction between needs in different care domains, and the evidence from risk assessments should be taken into account in deciding whether a recommendation of eligibility for NHS Comntinuing Healthcare should be made"

Note use of the word 'recommendation'. Nothing is certain, as we well know. So you should not have been told anything before the actual decision was made. Perhaps you can use that to your advantage? On the other hand, we also all know that the scores you received (remembering they always minimise what they see / read) would tell us that your mum is probably eligible - so fight on!

Thankyou forn this clarification. I agree that you should appeal. There is no reason why a Multidisciplinary Team should not tell you what they are recommending to the panel. If the letter you have received does not explain the exceptional circumstances then they have failed to follow the guidance on that count, in addition to the issues raised in the other contributions. I don't know what the protocol is on this site about offering help, but it is the reason I joined. My involvement with relatives and friends has been direct and personal, its the only way I can work. I write the letters for your approval, write the submissions for the Independent Review Panel and attend the panel to present the submission. I have done this on six occassions over the past two years in PCTs from my own in Wigan to Stoke and Lambeth, in each case successfully. If this is not what is required then this is not the forum for me. The reason I have not offered this more generally before is I can't deal with the whole country, but Derby is no problem.