Continuing Healthcare Appeals Service

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NHS Midlands and Lancashire can support your integrated care system (ICS) to provide individuals with the very best care.

Our Personalised Healthcare Commissioning team consists of clinical and administrative staff with over ten years’ experience in dealing with continuing healthcare appeals. We have established an excellent working relationship with NHS England and the Parliamentary Health Service Ombudsman, with excellent feedback on our local review processes, presentation of evidence files and our representation at panels.

Our team has:

  • Registered nurses qualified in adult mental health and general nursing
  • Social workers
  • Access to specialist children’s and learning disability nurses
  • Highly skilled administrators and business teams
  • Significant experience in planning and managing the transfer of services from providers
  • A track record in successfully integrating and merging processes.

We manage appeal requests and provide a suite of bespoke reports which highlight financial risks and processing reimbursement payments where required.

We can deliver this service as part of a commissioned end-to-end All Age Continuing Care service, or we can support you on a bespoke basis to meet the needs of the ICS which can also be funded on a case-by-case basis if required.

We provide:

  • Triage services including receipt, written consent, triage application, information gathering collation of relevant records and clinical review
  • Support at the Local Resolution Meeting with applicant including Final Decision Support Tool (DST), recommendation and eligibility decision which will be finalised with the ICS
  • Restitution payment, including calculating and processing a payment and Independent Review
  • Administration to record and process Independent Review requests
  • Reviews of Independent Review requests
  • Preparation and submission of the case file in line with NHS England requirements
  • An experienced clinician to prepare and represent the case
  • Completion of any post Independent Review correspondence and action plans 
  • Calculation of the value of a restitution payment to an individual.

We listen to and work in a collaborative way with customers and system partners to provide
subject matter expertise in the delivery of quality and excellence in your service whilst always ensuring that the individual and their representatives are the focus of our work, with the aim of delivering a
timely outcome of their review.

You can find more information about our Continuing Healthcare Appeals Service.

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