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Less than a month left to claim NHS care refunds

Older people and their families who were charged erroneously for NHS continuing healthcare have less than four weeks to claim a refund.

4 September 2012

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Flaws in the way that medical assessments of many sick and elderly people have been carried out by some primary care trusts mean that thousands of vulnerable people have been charged for nursing care they should have received for free.

Millions of pounds in refunds are anticipated as a backlog of more than 2,000 cases are determined. Health boards had already by the end of June refunded £3.6m to patients who were originally told they were not entitled to NHS continuing healthcare funding.

Currently, the NHS is supposed to pay for care for those with long-term medical needs. Those who need help with day-to-day living simply because of their old age have to fund themselves until their assets fall below £23,250.

However, some primary care trusts carried out medical assessments that failed to meet the national standard. For example, some may have been done without a family knowing, or may not have been repeated when a person’s condition deteriorated.

The government is now allowing retrospective claims for refunds in such cases and has set a deadline of September 30 for any claims that cover the period between 1 April 2004 and 31 March 2011.

Families can also submit claims in respect of those who have been in care, but have since died.

Cate Searle, director and head of community care law at martin searle solicitors, said in an article for Private Client Adviser back in May: “Elderly client advisers need to take prompt action to look through all of their cases to identify whether there is a potential claim for a refund of care fees.

“They need to pay particular attention to those cases where they act or acted as a deputy or attorney, and arguably those where they are dealing with probate in relation to someone who had significant care needs. A failure to identify potential cases could lead to the family taking ?action against the adviser, rather than against the NHS.

“However, they also need to be mindful about not starting what can be a very lengthy, costly and emotionally exhausting process for the family if the case lacks merit. An elderly client adviser who does not have expertise in this area of practice may want to seek an opinion from a more experienced NHS continuing healthcare adviser in at least some of their cases.”

Claims must be submitted to the PCT responsible for a person’s care.

For Cate’s full article on NHS continuing care see

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Vulnerable Clients