After a determined five-year battle, Compass CHC is proud to announce a significant victory for one of our clients, with the recovery of more than £160,000 in wrongly paid care fees.
The case began in June 2021, when our client’s father was assessed for NHS Continuing Healthcare (CHC) funding and was found ineligible by the Integrated Care Board (ICB). Despite a local appeal being rejected, Compass CHC refused to give up. We escalated the case to NHS England, the body responsible for undertaking independent reviews of eligibility decisions. NHS England agreed with our appeal and recommended that CHC funding should be awarded.
However, despite the clear recommendation from NHS England, the ICB refused to accept they had wrongfully denied our client funding. This prompted us to take the matter to the Parliamentary and Health Service Ombudsman.
After three more years of persistent complaints and appeals, the Ombudsman upheld the complaint and instructed the ICB to follow the original recommendation made by NHS England.
The ICB finally accepted that the patient was eligible for CHC funding. The decision means our client will recover over £160,000 in care fees that were wrongly paid during the appeal process.
Louis Seymour, Legal Services Director at Compass CHC, commented:
“This result is a testament to the expertise, resilience, and teamwork here at Compass CHC. I couldn’t be prouder of the team for their determination and persistence in fighting for the right outcome for our client. After such a long battle with the ICB, we hope this decision finally provides financial and emotional closure for the family and demonstrates why it is so pivotal to have an expert on your side.”
This case highlights the importance of expert support when navigating the complexities of CHC funding. It also demonstrates our unwavering commitment to securing justice for families facing inconsistent application of CHC national guidelines by different ICBs.
Not only did the ICB’s actions place unreasonable barriers to funding and cause incredibly stressful delays for our client, but they also resulted in greater costs to public funds, including interest accrued during the prolonged appeal process.
Learn more: How do I appeal an NHS Continuing Healthcare funding decision?
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