Posted: Friday, 4 January 2019 @ 13:43
Broadly speaking there are three steps to challenging an assessment decision which goes against your family.
These are:
1 Ask the CCG to review your case. Explain why you want your case reviewed and why you think the person is eligible for NHS continuing healthcare.
2 If the CCG decides you are still not eligible, you can obtain a review from an independent review panel (IRP).
3 If the IRP does not go with you, you can take your case the Parliamentary and Health Service Ombudsman.
Within this framework what are the variables which enable one to have more chance of success throughout the process?
Specifically, what can you do to win?
1 Sound organisation - If you are organised such as with your note taking, record taking that will put you in a stronger position for the successful conduct of such a case.
2 Communicating Calmly Verbally with the People Making the Decisions - Too often I have seen both family members(and lawyers) dealing with a difficult situation and sometimes social workers/assessors by being overly aggressive in person with them and picking them on any perceived error/sleight on them. Remember Assertive is good. Aggressive is not good and will backfire whatever the provocation.
3 Objective Analysis of Your Case - It is natural to think one has a strong legal case even when you do not and the difficult issues you are going through. Alternatively you may have a stronger case then you think. Therefore where you can get someone externally(be that a knowledgeable colleague or a professional) to advise on how strong your prospects are. If you know where you are, you have a better chance of knowing what is required to win.
4 Create A Positive Narrative - Ultimately your goal is to obtain funding for the family member. Never lose sight of that fact. The key aspect of any appeal and legal document that goes is that you consistently create a strong story as to why the family member should obtain care. This has impact upon who is reading including yourself. It gives you confidence in the case and makes the receiving party pay attention too.
5 Succint Written Communication - In most legal cases the capacity to win is not based on the strength of the case(though that is a important factor) but rather the capacity to put forward our case with lots of(not uncomplicated) information in a way that is appealing to read/be considered . Resist the tendency to put the kitchen sink in - less is more in this kind of case.