Family recovers over £117,000 in wrongly paid fees after seven year fight
09 | 11 | 2011
Following a seven year fight
with the help of Hugh James nursing care, the NHS have admitted
that their decision on care fees was wrong and the family of Mrs
Evangeline McConnell have finally been reimbursed with £117,000 in
wrongly paid care home fees.
Eighty eight year old Evangeline
McConnell suffered a severe stroke in October 2002 and was admitted
to the Royal Albert Edward Hospital in Wigan. She was then
transferred to Leigh Infirmary in Lancashire for six months
for rehabilitation. However, the family were informed that she
could not return home as she required 24 hour nursing care.
Mrs McConnell was then admitted to the Arncliffe Court Nursing Home
in Halewood, Liverpool in April 2003 and later to St Bartholomews
Court Nursing Home in Huyton, Merseyside where she sadly died on
the 3 November 2011.
The family were told that due to
Mrs McConnell’s capital and income, she would have to pay for her
own nursing care costs. Mr Phil McConnell, Evangeline’s son, asked
the NHS for an assessment before she was discharged from hospital
in 2003. However, the NHS said that she was stable and not complex
and therefore not eligible. This meant that she became the
responsibility of the social services and due to her capital and
income, had to sell her home to pay for her nursing care fees of
£2,000 per month.
Mr McConnell said: “The only reason
my mother needed to go into a nursing home was because she was very
ill and required 24 hour nursing care.”
He went on to say “I was aware of
NHS Continuing Healthcare and asked the hospital to assess my
mother. I was shocked when they said she did not meet the criteria.
I appealed the decision as I felt it was clear that my mother
should have had her fees paid by the NHS. In 2004, I was told I had
lost my appeal. I was very upset and angry and felt that the system
was so complex and unfair that I gave up”.
Continuing healthcare is where the
NHS is responsible for, and fully funds care - it mainly affects
very ill patients, often elderly, in nursing homes; but can also
apply if a person is in hospital long term or needs nursing care at
home.
Mrs McConnell had suffered a
catastrophic stroke which resulted in her being immobile,
incontinent, unable to communicate and swallow. She was
totally reliant on two to three carers to attend to all
her needs and a tube was placed in her stomach to provide her with
nutrition and medication. Yet, the NHS maintained that she did not
have ‘health needs’ which meant she was entitled to NHS Continuing
Healthcare. The family, helped by Hugh James, had to prove that her
health and living needs meant she should never have had to pay her
own care home fees.
Despite regular assessments, it was
not until January 2008 that Mrs McConnell was assessed as meeting
the criteria and all her future fees were to be paid by the NHS. Mr
McConnell said: “I was very pleased when the NHS finally accepted
that my mother was eligible for NHS Continuing Healthcare. It was
however obvious to me that her needs had not changed and she should
have always been their responsibility. The system is so complex but
I was determined to challenge their previous decision. They put so
many obstacles in our way and I would have given up without
assistance. It has been a hard and long seven year fight, but
I am happy that the NHS have finally admitted that they should have
been responsible for my mum’s nursing home fees and have reimbursed
her all the money.” Fortunately Mrs McConnell received the money
which she was due prior to her death in November 2011.
Lisa Morgan, Partner and a member
of the specialist Nursing Care Team at Welsh law firm Hugh James
acts for the Mrs McConnell and her family and says that this is a
common story: “Thousands of people across England and Wales are
being wrongly charged for nursing care and in many cases, they are
forced to sell their family home to pay. If the primary reason a
person is in a care home is because of their health, all costs
should be met for free by the NHS. To date, we have recovered over
eighteen million pounds in nursing home fees on behalf of our
clients.”
Lisa Morgan adds: “Mrs McConnell’s
family were forced to sell her home to fund the nursing home fees.
If the NHS had made the correct decision in 2003, the distress and
heartache to the family could have been avoided”. Under current
policy a person should be the responsibility of the NHS if their
primary need is health. However, in many cases, Local Health Boards
in Wales and Primary Care Trusts in England are not applying the
correct legal test.
Read more about Mrs Evangeline McConnell's
case
