At Sydney Mitchell we have extensive experience supporting families through continuing healthcare assessments and appeals.
If continuing healthcare (CHC) funding has been denied or withdrawn following a review, you don’t have to accept the decision without question. Many families find themselves in situations where their loved one’s needs are categorised as “social” rather than “health,” or where the decision support tool (DST) scoring doesn’t accurately reflect the daily realities.
What is the process?
CHC decisions can often be successfully challenged when evidence is clearly presented and the decision is scrutinized against the national framework.
We provide assistance to families throughout England in contesting CHC decisions. Our support includes:
- Addressing funding withdrawals that occur during review periods of three or twelve.
- Challenging refusals of CHC funding following multi-disciplinary team (MDT) evaluations.
- Handling cases where the Decision Support Tool (DST) inconsistently reflects care notes, incident logs, or clinical records.
- Contesting denials of eligibility based on needs being labelled as “social care”.
- Navigating complex situations involving dementia, challenging behaviour, falls, or high-risk needs.
Retrospective CHC appeals
Even after a loved one has died it may be prudent for families to seek a review of care needs to see whether the criteria for continuing healthcare funding may have been met by the deceased during care periods just before they died, thus maximising the deceased’s estate.
Beneficiaries of estates increasingly question whether the executors have discharged their responsibilities in realising the full value of the deceased’s estate. Similarly attorneys are being questioned more frequently to assess whether their duties during the deceased’s lifetime were carried out effectively and particularly whether timely advice was sought in respect of the care costs.
Find out more about the team
