Is corruption at CCG board level for NHS Continuing Healthcare?
Whilst my MP, Leo Docherty, dutifully ignored my evidence and simply accepted the lies and misleading information from West Hampshire CCG, one positive did come out of his involvement. I asked him to request a meeting between myself and the CCG to discuss the failings in process of the NHS Continuing Healthcare review. This eventually went ahead in June 2019, although the CCG were adamant that the unlawful reassessment of my wife’s eligibility would go ahead irrespective of this meeting.
This, in itself, raises the ugly truth that the CCG were not prepared to listen to an evidenced viewpoint with a mindset of correcting any errors.
So what happened at the meeting?
I attended alongside my data protection consultant. For West Hampshire CCG, the following people were present:
· Heather Hauschild (Chief Officer)
· Ellen McNicholas (Director for Quality and Board Nurse)
· Dr Stuart Ward (Board Member)
· Judy Gillow (Board Member)
· Diane Bittlestone (Complaints Manager)
Dr Sarah Schofield, Chair of the Board, was due to be present but was unable to attend.
In brief, irrespective of the evidence, Heather Hauschild and Ellen McNicolas spent 45 minutes belligerently stating the case would go to MDT for reassessment. And then there was the glorious moment… I asked what evidence they had that contradicted some of the points I was raising.
The silence was golden. In fact, the silence went on for so long, I’m sure I saw tumbleweed gently rolling across the table.
Step forward, Dr Stuart Ward. As far as the records shared with me show, he had no involvement in the case prior to the meeting. In order to ‘draw a line in the sand’, he cancelled the MDT for reassessment.
But there was a caveat.
There was no admission of any wrongdoing.
This was a significant victory but it did not protect me and my family from the same failings happening again in the future. And, considering the significant harm to me and my family, there was no sense of justice. But at least we were able to move forward, and Ellen McNicholas (Director for Quality and Board Nurse) was tasked to responding to specific issues raised in the meeting. See wrote back to me on 4 September 2019.
So, here we go. Dear Ellen McNicholas…
Funding Agreement with the Care Agency
“We do not have any documentation in our records that confirms that the package of care was agreed at 2868 hours per year (55 x 52 weeks) to be used flexibly, with the understanding that term time would use many more hours whilst school holiday periods would be less. This is not to say that this was not agreed, but we do not have any evidence in the case file that supports that the care package was set up as annual hours rather than weekly hours.”
Dear Ellen McNicholas… You have clearly gone through the archives because so much of your information came from information sent to me in a Subject Access Request from the archive. However, you clearly were not thorough enough. It also appears that you cherry-picked information. The figures you provided were from discussions, not the final agreement. The final figure for the annual budget was over 50% more than you claimed in your letter.
(Note – Highlighting was done by me on copy of records)
Next time, I suggest you ask for help. I would have been able to provide the information very quickly and easily. After three years, you and West Hampshire CCG were still getting it wrong. The new CEO only needed 24 hours to identify that I was correct when the same issues arose in 2020.
Reason for the Reviews
“The CHC team received a letter from you dated 14 September 2017 raising a concern that [the care agency] were unable to claim for more than 55 hours per weeks, as it was your understanding that there was flexibility in the care package up to 2868 hours per year. As the team were unable to find confirmation on our system of this arrangement being in place they schedules a review as would be our standard process. In addition it is reported by our administration team that they received a call from [the care agency] stating that the carers for Mrs Austen-Jones were only providing cleaning and driving services.”
Dear Ellen McNicholas… Where do I begin?
1. It wasn’t just my understanding. The care package had been operating on a flexible basis since its inception in 2009. We have the evidence of this. Furthermore, the evidence above shows it was flexible.
2. “Standard practice” to conduct a review in these circumstances? Why oh why do you insist on telling lies to try to get out of trouble? It is not ‘standard practice’. It would have required a simple phone call to me. The CCG would have admitted they couldn’t find the records; I would been somewhat annoyed; I would have provided the evidence; the whole situation would have resolved. THIS IS WHAT SHOULD HAVE HAPPENED AND IS THE PROCESS SHOWN IN YOUR STANDARD OPERATING PROCEDURE.
The letter of 14 September 2017 was received by Roy Dube, the case coordinator for the November 2017 review. The irony is not lost on me.
3. You claim that the admin team recollect a phone call from the care agency. But what happened to the evidence that is on CONI (your computer system) of the phone call and the correspondence? Why don’t you just provide me with that.
4. I am deeply troubled by your claim that the care agency believe they are only providing driving and cleaning services. This is a major safeguarding concern. My wife has a life-threatening condition that requires urgent medical assistance. Clearly the care plan will be inappropriate and they won’t be providing appropriately trained carers. Please provide the evidence as this needs reporting to the CQC. Either that, or your admin team’s “recollection” is not really very reliable or untrue.
“I apologise if the purpose of this review was not made clear to you at the time. As Roy Dube who carried out the review no longer works for the CCG I am unable to confirm what discussion he had with you on the day about the purpose of the review.”
Dear Ellen McNicholas… All you had to do was ask me. I’ve got a recording of the meeting. And, more to the point, why didn’t anyone ask him when I first raised the issue? Or the second time? Or the third time? Or the fourth time?...
“It is noted in the review that the case coordinator discussed with you the need to review the number of hours provided with a view to reducing the care hours during the day. It is also noted that your response was that you would not agree to any changes. As a result of his review the Case Coordinator recommended that a DST meeting to assess eligibility for CHC funding was required.”
Dear Ellen McNicholas… You have based your judgement on the case coordinator’s review report. You have ignored the issues we raised and can evidence through the recording of the meeting (ie he accepted my wife was eligible but when we disputed the reduction in care during the day he changed the outcome to may no longer be eligible). Is your investigation into this matter biased, incompetent or negligent, or a combination of all three?
January 2018 Review
“As you did not agree with the outcome of the November 2017 review the team arranged for a further review in January 2018.”
Dear Ellen McNicholas… You are quite right, we did not agree with the outcome of the November 2017 review. But, whilst some key matters were ignored, Heather Hauschild accepted that there were some significant failings in the review (not reading all available evidence from medical experts and failing to interpret the seizure record correctly). Your blatant attempt at spin on this matter is noted. It is also noted that you have not mentioned the fake guidelines that were used in the January 2018 review.
Input by Pauline Dorn and Meriel Chamberlain
“Our investigation has confirmed that Meriel Chamberlain did not carry out a review. As Operational Manager, she provided management advice to Jo Craven following the review in January 2018 as Jo wanted to discuss the review with a manager.”
Dear Ellen McNicholas… The January 2018 review report states that Meriel Chamberlain reviewed the evidence, although there is no other evidence to back this up. Meriel Chamberlain had the score for Altered State of Consciousness lowered to below severe. You are absolutely right that Jo Craven sought advice. But your statement appears to be a clear attempt at a cover up. You clearly have no idea or no wish to seek the evidence, which is available, that proves what the management advice sought was actually for. I have repeatedly told you and West Hampshire CCG but you choose to ignore it. Jo Craven felt that my wife clearly remained eligible and was seeking a manager to overturn the fake guidelines that were being implemented. Furthermore, she had no consent to discuss my wife’s case with a manager beyond the basic point of 1 Priority domain and 2 Severe domains being sent to MDT.
“Similarly Pauline Dorn did not carry out a review. As Head of the Continuing Healthcare Service she looked at the case file to respond to your complaints and to prepare for the complaint local resolution meeting.”
Dear Ellen McNicholas… You clearly have not looked at the following document.
This was a review of the evidence from the January 2018 review in comparison to the original DST.
There is a great irony in what you say, though. Of course, it is not a review in the terms of the National Framework. That would require us to have knowledge and involvement in it. This review was done behind our back without consent. Her judgement determined the outcome of our complaint prior to investigation of the issues in the complaint.
And, Ellen McNicholas, our complaint did not raise concerns about the scorings determined in the review. As such, her review was not done in order to respond to our complaints and to prepare for the complaint local resolution meeting. It was done to make a clinical judgement on the basis of her review, having never even met my wife.
“Once again I am sorry if the use of the word review to describe their input has caused confusion.”
Dear Ellen McNicholas… Seriously? The only thing I am confused about is why you don’t just admit that West Hampshire CCG have treated me and my family so badly.
Consent for Reviews
“It is apparent that you were given many different reasons for the review being conducted. I apologise if you were not fully informed of the reasons for the reviews in November 2017 and January 2018.”
Dear Ellen McNicholas… If? What do you mean by ‘if’? It is blatantly obvious we were not appropriately informed. Even now you cannot admit it. And the ever-changing attempts at blaming the care agency for the review is just a disgrace.
“We have strengthened our process to ensure that our staff clarify at the outset of every review meeting the purpose of the meeting to ensure that we have informed consent.”
Dear Ellen McNicholas… And I assume by this you also mean you provide evidence of the reason for the review as well. But I am still confused by your statement. The most recent letter I received from the newly formed amalgamated CCG states that consent is not the legal basis used for reviews. If informed consent is not the legal basis the CCG is using for processing sensitive personal data, why are you obtaining consent at all? But that is a story for another time.
I note that your title is Director of Quality and Board Nurse. I am interested to know the sort of qualities you are looking for when you recruit staff. In the meantime, I must go and look up the definition of oxymoron.
When the failings in NHS Continuing Healthcare are at the top of the organisation, it is no wonder there is a national NHS Continuing Healthcare Scandal. To find out more, please visit nhschcscandal.co.uk and https://www.crowdjustice.com/case/the-nhs-continuing-healthcare-scandal/