No win, no fee

[Tilly2]

With reference to my care home fee problems, (see earlier posts) one of my relatives has given me details of an organisation which will fight for fees to be paid by the NHS. My Dad fits the criteria for eligibility and I am considering getting in touch with them. They fight your case with the PCT and its no win, no fee.

Is there anything I need to be wary of before going down this route?

[bednobs]

if he fits the criteria, you don't need a company to do it - he will be assessed and awarded it.

[Tilly2]

Thank you, bednobs. I did think that myself but don't know where to start. With the PCT I suppose.

[bednobs]

well i assume that no win no fee means if you do win there will be a fee! I think you need to steel yourself though for the fact that although it may seem to you like he fits the criteria, he may not according to the person who does the assessing or the PCT. NHS funding is extremely hard to get, mainly because it's so expensive that the PCT want to have minimum amounts of people on it. each person on full nhs funding probably costs the PCT 50 k a year at least

[atalanta]

You can appoint an advocate, who will ask for an hourly fee with expenses. He or she will go through the care-home's case notes, to see if there are any outstanding features which must be brought to the attention of the NHS assessors. You may attend the hearing, the advocate will attend the hearing, and one or two representatives of the NHS will attend. He will be assessed on a set of charts, such as "behaviour" " night needs", "mobility" and "Drug treatment" among others.I think there are 9 categories. If he scores the very worst score on two categories, he is eligible. If you do not agree with these assessments, you can appeal. It will almost certainly be cheaper to pay an advocate than to pay a set of lawyers for a no-win-no-fee if you are so sure he will get the NHS agreement. (Think of it - an average care home may charge over £30,00 p.a, and you may have to agree to give away 40 or 50 percent.) The Court of Protection (Office of the Public Guardian) may be able to give you the names of their "Visitors" - some of whom act as advocates.

[atalanta]

I meant the cost per annum could be £30,000.
Oops

[woofgang]

Go to the PALS department of your PCT. They have one function which is to assist patients and their representatives

[Tilly2]

Thank you all for your help with this. The organisation I was looking at would charge 25% of whatever the 'win' was.
I will look into advocacy and contact the PCT.

Atlanta would the fact that Dad was getting Attendance Allowance, before he went into the home, have any bearing on his eligibility?

[bednobs]

hiya, none at all i'm afraid. i dont get what the "win" is -it's not like you or your father actually get any money out of getting NHS funding, so i'm not sure what they mean by 25%

[Tilly2]

Bednods, the win would be the last six years of fees which my Dad has already paid. They would take their 25% from that money.

[woofgang]

Very very difficult to get such things backdated unless you can prove that they would have been entitled from the first assessment

[atalanta]

It depends what the attendance allowance was for, but it would only indirectly make a difference. If the allowance was granted because he was suffering from dementia, it would depend how bad the dementia was. Presumably dementia does not get better, but sometimes dementia gets so much worse that the patient can no longer cxause difficulties, such as screaming all night, so he is deemed to be "better", in that respect. If the allowance was for mobility problems, these are taken into account in the assessments, in one of the categories I mentioned before.

[Tilly2]

That's what this company say they can do, woofgang. I will fill in the criteria form and they will assess the likelihood of winning or losing.