WE all know that NHS care is ‘free at the point of delivery’ and is provided to us all regardless of our financial circumstances.

We are accustomed to receiving our health care for free ‘from cradle to grave’ – so it can come as a shock to realise when we have become old and infirm, our care needs are not considered health ones met by the NHS, but should be paid for from our savings built up over a lifetime of hard work.

As we have discussed in these features previously, if the care an individual needs is primarily health-related then that care should by law be funded by the NHS.

Defining a health need is critical and we have previously considered the assessment process for accessing that NHS funding – known as Continuing Health Care (CHC).

This month we look at what to do if you disagree with the decision reached after that initial assessment process.

Perhaps it has been decided that your care needs are social ones, to be funded by the local authority and be subject to a means test; or perhaps, whilst acknowledging the number and degree of health conditions you face, none of them are considered sufficiently severe to merit NHS funding.

The procedure for challenging an NHS CHC decision is not a legalistic one, and is deliberately designed to be as informal as possible.

You will see from the table that every effort must be made to resolve any disagreement at a local level.

The appeal, through the relevant Clinical Commissioning Group (CCG), may be made by you or your carer and can be by letter.

If you disagree with the decision reached, set out your reasons for believing that CHC should be granted.

Keep a careful track of the exact procedure which is followed, as any failings in the process can be a ground for appeal at the Independent Review Panel (IRP) stage, which is arranged through NHS England.

The timescales imposed by the National Framework for CHC are tight, and many CCGs have struggled to meet these in the past. Ask for copies of all records as, again, failure to keep full and accurate care records is often criticised at the IRP.

Our experience at Ashfords indicates that it is becoming harder to achieve NHS CHC funding.

We regularly advise that you can expect the first claim to be rejected and that you will need to appeal. We also advise that the process can be long and drawn out, and that you need to persevere in your claim. This can be distressing for family members who can see their loved ones needing increasing care, with poor prospects of recovery.

The recognition that nursing care is needed for an elderly relative is often part of the reason for making a CHC claim. Families can be very reluctant to appeal any decision for fear of disrupting their loved one's care. We often need to reassure family members of their entitlements and not to be shy in seeking help.

Ashfords has solicitors who are members of the Society of Trusts and Estate Practitioners (STEP) and Solicitors for the Elderly who have particular expertise in advising on issues facing elderly clients.

ASHFORDS PARTNER SUE SAVILL.