Is the truth required from a CCG at a Local Resolution Meeting for NHS Continuing Healthcare?
Recap of timeline
Sept 2017 – Care agency inform us that CCG is limiting hours per week for life-saving care, contrary to the agreed package of care.
8 Nov 2017 – West Hampshire CCG conducts a review of my wife’s NHS Continuing Healthcare package and misled (lied to?) us about the reasoning.
10 Nov 2017 – Formal complaint from us for multiple reasons about the review, including the reviewer changing the outcome because we said we would appeal a reduction in care.
21 Dec 2017 – Complaint response, accepting some failings and offering a new review. Local Resolution Meeting (LRM) offered if we were not happy with the response.
23 January 2018 – New review. Fake guidelines used to force a Multi-Disciplinary Team (MDT) meeting to reassess eligibility.
24 January 2018 – We sent letter questioning the process to call an MDT.
28 January 2018 – We requested LRM to discuss unresolved matters from November review complaint.
5 February 2018 – Received January review report with unlawful alterations to outcome.
7 February 2018 – Formal complaint about process of January review and subsequent actions of CCG.
By law (The Local Authority Social Services and NHS Complaints (England) Regulations 2009 – Para 13 (7)(a)), and in accordance with West Hampshire CCG policy (Policy for Management of Complaints 3.6.3), it is a requirement for the CCG to discuss our complaint prior to investigation. This ensures proper understanding of the complaint and desired outcomes.
The LRM, to discuss remaining issues with our November review complaint, was already booked for 15 February 2018. We received an email stating that we could discuss our second complaint at that meeting. This seemed fine to us and in accordance with law and policy.
BUT WEST HAMPSHIRE CCG HAD OTHER IDEAS
As highlighted in the previous blog post, the head of CHC, in agreement with the deputy director of CHC and a complaints manager, unlawfully reviewed my wife’s clinical records and erroneously decided to continue with the MDT. This was done on 13 February 2018, two days prior to the LRM.
WHAT HAPPENED AT THE LOCAL RESOLUTION MEETING WAS A DISGRACE
The head of CHC and the complaints manager spent an hour telling us that our case had to go to MDT due to the paperwork. They then tried to end the meeting. No discussion of the actual issues that the LRM was called for – the November 2017 review.
BUT IT IS WORSE THAN THAT
Unless the head of CHC and the complaint manager were both suffering from short-term memory loss, they lied to us. Let’s look at some of the quotes from the meeting:
“I can’t question the review paperwork that has now been completed” – so why re-review the case two days earlier and chooseto continue with the MDT?
“I acknowledge that what was said to you in the meeting differs from the review paperwork that has now been completed. I will take that back as not best practice. So that’s not something that should happen. It should be that the outcome from review that is agreed with the relatives or the patient themselves and that’s the outcome that is then taken forward.” – So, it is admitted that the review paperwork should not have been altered yet WHCCG are saying they have to go by the altered paperwork. All that WHCCG needed to do was abide by the complaints policy (appendix 5) and undo the inappropriate changes.
“I agree, that two severe and a priority would indicate a Primary Health Need.” That is great. It means a mistake occurred which can be corrected by cancelling the MDT.
I stated, “You have accepted that with the meeting there was not evidence that Rach would not meet criteria.”The response? “Yes.” It was admitted that the reviewer should not have determined MDT. So why ignore the WHCCG complaint policy (appendix 5) and not revert us to the position as if the mistake had not occurred?
I stated, “So basically, you’ve come to this meeting knowing that actually we are going to MDT.” The response? “It has to go to MDT, yes.” Yet the only ‘investigation’ at this point was her unlawful re-review of the evidence.
I stated, “that is accepted, that Rach does have a Primary Health Need on the basis of that review and yet we can’t change the decision?” The response? “No, because the evidence was then reviewed and I haven’t seen the evidence to review for myself.” My father was at the meeting and responded, “But that review of evidence should never have taken place.” The response? “I can only apologise for the process that has been followed. The outcome still has to stand.” Considering the CHC reviewed the evidence to pre-determine the outcome of the complaint just two days earlier, I would love to receive feedback from West Hampshire CCG, Hampshire County Council, the NMC and the PHSO on this. Am I really the only person thinking that we were lied to?
“It is under investigation. We had already got this meeting scheduled and we hoped to be able to resolve as much as we could face to face and we will be formally responding to the complaint, but we can gather from today what our recommendation will still be from that.” Internal emails prove that the investigation into the issues we raised in our complaint took place afterthe meeting. “It is under investigation…” – but the investigation had not started yet they had determined the outcome.
It is easy for us to prove these quotes as WHCCG recorded the meeting, with our agreement, and provided us with a copy. To date, West Hampshire has yet to provide any direct response to specific issues we have raised regarding the claims made in the LRM.
It is clear to us that West Hampshire CCG has had no regard to policies and regulations unless it suited them. We strongly believe that there has been a concerted effort to reduce or remove the life-saving care package from my wife. Why else would West Hampshire CCG go against their own policies, the National Framework for NHS Continuing Healthcare, and the law?
Futhermore, when we reported it to Hampshire County Council under safeguarding, with little information sent from the CCG (and what was sent was blatantly misleading), how did the County Council respond to West Hampshire? “We are happy with the CCG’s approach.” Future posts will focus more on the actions/inactions of Hampshire County Council (and their strong links to individuals involved in our case from West Hampshire CCG), the NMC and the PHSO.
These matters have been raised with Hampshire County Council, the Nursing and Midwifery Council (NMC), and the Parliamentary and Health Service Ombudsman (PHSO) and other organisations. It appears that they all have a woefully poor comprehension of data protection law (in particular regarding consent), NHS Continuing Healthcare regulations and policy, and complaints regulations and policy. Being a family member of a victim of the Gosport War Memorial Hospital scandal, I fear that it is more sinister. Rather than protect patients, it seems they are more interested in protecting the reputation of the NHS. I will address the actions/inactions of organisations such as Hampshire County Council, the NMC and the PHSO.
Please look at the campaign being led by Rear Admiral Philip Mathias (nhschcscandal.co.uk). He is seeking a judicial review into the NHS Continuing Healthcare scandal. Our story is just one of many, many thousands. Please support and spread the word of the campaign as much as possible. My blog shows the fight individuals are up against to obtain their lawful entitlement to essential, including in some cases likes ours life-saving, healthcare. The campaign already has the support of the Continuing Healthcare Alliance (eighteen charities and organisations) and numerous individuals such as Dame Esther Rantzen, Fiona Phillips, Jimmy McGovern and John Stiles (son of World Cup ’66 winner Nobby Stiles).
Post-script - as usual, I have provided this blog in advance to West Hampshire CCG. They have not informed me of any factual inaccuracies.