I qualified as a nurse from the University of Greenwich and my first job as a staff nurse was in a day surgery unit, where I completed my preceptorship. From there I moved into specialist nursing, again working as a staff nurse in a cancer unit for many years. This is where I began to get regularly involved in assessing patients for CHC as a member of the multi-disciplinary team (MDT) who would meet to make the assessment. I also worked in emergency care and then left the NHS to take up nursing as a medical case manager in the private sector and then moved on to become nursing manager for a nationwide live-in care provider. I returned to the NHS as a Charge Nurse (the male version of a ward Sister) in a community hospital until retiring from the profession. I regularly refresh and update my clinical knowledge and developments within CHC.
As I became more familiar with the CHC assessment process it became increasingly obvious that CHC decision makers would often employ a variety of tactics to deny applications or ignore the Framework which underpins the process. Whilst being a member of the MDT gave me an opportunity to advocate for the patient, I was often overruled by the decision maker which was frustrating and deeply concerning. As the National Audit Office report into CHC dated July 2017 stated, CHC is a postcode lottery.
CHC assessments should be undertaken by assessors who are completely independent of the NHS, as should the appeal process, including Independent Review Panels which in reality are very much part of the NHS.
Until this happens, many thousands of people may be unlawfully paying for their care.