Nursing Care fee recovery

Our team of specialist nursing care lawyers can help you whether you need to request a NHS Continuing Health Care (CHC) assessment, make an appeal for an CHC funding decision or you need to claim back nursing care fees that should not have been paid. We will always do our very best to get you the result that you are looking for. However, there are very strict deadlines so it is important that you fill in the form below as soon as possible to give you the best chance of success.

Our team have been working in this area for over 15 years and have been successful for over 6000 families in securing free funding. We have also recovered £200m for our clients. The most any one firm has recovered in the UK.

There are many firms who provide advocacy services in this area, so why should you instruct a solicitor?

• We act independently and will also provide you with an impartial appraisal of your case
• Solicitors are regulated by the Solicitors Regulatory Authority. This confers many benefits:
• The SRA imposes a strict code of conduct and we must act independently and in our clients best interest
• Regulation also provides clients with certain protections should things go wrong:
  • Solicitors must have professional negligence insurance
  • Solicitor firms must have complaints procedure if you are unhappy with the service received
  • The Legal Ombudsman can be contacted to investigate complaints if you are not satisfied with an internal complaints procedure

As solicitors we must be open and transparent about the cost to instructing us. We offer a number of funding options which will be provided to you in writing. It is important you fully understand the options available to you.

It is possible for you to pursue a claim independently without instructing a solicitor or advocate. However, it is a difficult process and we have many clients who have initially tried themselves and found the process challenging.

There are many companies who specialise in this area. However, as solicitors we are regulated and very experienced in what we do.

The team at Hugh James have more than 15 years of experience and have won awards from The Law Society and Age Cymru for their work.

Some of our clients question how non-medically qualified professionals can challenge health decisions. Whilst the people making decisions regarding eligibility for continuing healthcare are health and social care professionals, their decisions are being challenged and it is our job to demonstrate they are unsound by analysing medical evidence and applying it to the criteria. Whilst the process is not legal, it is a dispute resolution process and many Independent Review Panel chairs are former solicitors and barristers.

Due to Hugh James experience and depth of knowledge, we are respected by health and social care professions and panel chairs for the work we do.

The skills developed by lawyers – analytical, evaluating, interpreting and advocacy is key in being successful and it is of no surprise that all companies employ law graduates to undertake this work.

Unlike solicitors, unregulated advocacy companies are not obliged to provide clients with the best advice and be clear and transparent about their charges. They cannot advise on the option of court proceedings against health authorities for unsound decisions by way of Judicial Review, as they cannot by law undertake reserved legal activities. NHS Continuing Healthcare: Can you challenge an Independent Review Panel decision?

The other added advantage of instructing a solicitor is protection if something goes wrong. Sadly, we have seen first-hand, companies not providing accurate advice leading to clients losing the chance to proceed or companies no longer being in business. Solicitor practices are far more stable, but in the unlikely event that something does go wrong, clients can at least rely on solicitor’s professional insurance policy. They can also have recourse to the Solicitors Compensation Fund.

While we will ask the case proceeds as soon as possible, we have no control over the speed in which the health authorities progress the claim and it depends on the decisions made by the health authority. In our experience, it takes 24 months for a case to reach a retrospective panel. However, current assessment should be undertaken in a timely manner and are usually completed within 3-6 months. We will always keep you up to date as your case progresses.

Our team have been working in this area for over 15 years and have been successful for over 6000 families in securing free NHS funding through current assessment and/or retrospective reviews.

We provide a free initial assessment and we will advise you at the outset whether you have a case.

We have recovered £200m for our clients. The most any one firm or company has recovered in the UK.

Read what our clients say about our service here.

We act on behalf of individuals, families and for advocates. We instigate current assessments, appeals and retrospective reviews. We have also acted for families in securing s.117 aftercare funding from the local authority and in cases where families are paying a top-up. We will also proceed with bringing court proceedings against health authorities by way of judicial review claims.

We continue to appraise the case as it progresses and provide you with advice at each stage. We do not raise our client’s expectation and if we consider that your claim is unlikely to succeed at any stage, we will let you know. The NHS Continuing Healthcare appeal process is difficult for individuals and their families and it is not in our clients’ interest to proceed with a claim if it will fail.

Although the review process is effective and most claims settle, we cannot guarantee success.

If you remain dissatisfied at the end of the review it may be necessary at that stage to consider issuing court proceedings. The purpose of those proceedings would be to challenge the decision of the review panel. We should point out that challenging those decisions are not straight forward and the grounds for challenging are limited.

We are pleased to say most claims settle without the need to issue court proceedings. In the unlikely event that consideration needs to be given to issuing court proceedings we will discuss matters further with you at that stage and there will be no obligation on you to proceed.

The process will depend on a number of factors, such as whether you are starting your claim from scratch or if you are coming to us to appeal a negative decision; whether you are claiming on behalf of a loved one who has since passed away or has just moved into long-term care.

If you believe that you or a family member has wrongly paid care fees, then the first step is to complete our questionnaire. This will be assessed by our Nursing Care legal team who will be able to advise on whether or not you have a case, and if so, what the process will be. This initial questionnaire is free to complete and there is no obligation on you to proceed with a claim should you decide not to.

We believe we are one of the leading national experts in the recovery of wrongly paid care home fees. Here are just some of the reasons why our clients choose to work with us:

• We have recovered over £200 million in wrongly paid nursing home fees since the department was set up in 2006.
• Our success and client stories are regularly featured in the press as we are recognised as leading the way in reclaiming wrongly paid care home fees. This includes The One Show, Dispatches, ITV News, The Telegraph, The Sunday Times and The Mirror.
• We work in partnership with many of the leading older peoples’ charities, helping us to ensure our service meets the needs of the people we, and the charities, represent.
• Unlike many other companies who focus on reclaiming wrongly paid care fees, we are a firm of solicitors regulated by the Solicitors Regulatory Authority (SRA) and comply with the solicitors’ code of conduct.
• The Hugh James Nursing Care team is the leading and most experienced team in the niche area of continuing healthcare, giving you complete peace of mind that your case is being dealt with by fully qualified lawyers who specialise in reclaiming nursing and care home fees.
• The team is also one of the biggest teams focusing exclusively on this area in the UK with over 40 dedicated lawyers.
• We promise to deal with your claim from start to finish and will not pass your claim on to a third party. We offer a complete service for you with dedicated team members to contact.
• Head of the team, Lisa Morgan, won the highly acclaimed Law Society Junior Lawyer of the Year 2010 Excellence Award due to her work in this area. She was also recently awarded the Cardiff University Simon Mumford award. In 2017, the department was highly commended at the Age Cymru Awards in the large business category for its commitment to helping older people.

We deal with a wide range of clients across England and Wales.

In theory, yes. However, you cannot simply appeal because you disagree with the outcome of the decision. You can ask for a review of the decision to refuse funding if the correct procedures have not been followed or the application of the eligibility criteria have been incorrectly applied. You may also only be given a limited time to appeal a decision so it’s important you read any letters you receive carefully.

In the first instance you should direct your appeal to the Clinical Commissioning Group in England or Health Board in Wales. The review systems in England and Wales are different and can be complicated.

If you are a client of ours, we will conduct the appeal on your behalf with your authorisation.

Yes, it is possible to retrospectively claim back money paid on care home fees even if the individual who received the care has now passed away. We have successfully done this for many clients.

It is the local authority (social services), rather than the NHS who are responsible for care if you are found not eligible for NHS Continuing Healthcare. Unlike the NHS, social services are able to assess the individual’s ability to pay. This will mean that they will conduct a financial assessment.

There is an upper and lower capital limit. This means that if a person has savings which amount to more than the upper capital limit, they will have to pay the full cost of their care home placement until their savings reduce to that limit. If an individual has savings which are worth less than the lower capital limit, then a local authority social services department will fund the cost of care. A person who is in between the capital limits will have to make a contribution to their care costs on a tariff rate depending on how much they exceed the minimum.

Your savings include any money in bank and building society accounts, stocks and shares, and property (land and buildings). Any joint ownership is counted according to that person’s share.

The capital limits are different in England and Wales. Please check the Government website to find the capital limits where you live.

The application process for NHS Continuing Healthcare is very complex. Although you don’t need to work with a solicitor to get the funding, working with an expert in the field will significantly increase your chances of getting NHS Continuing Healthcare eligibility.

Clinical Commissioning Groups  in England and Health Boards in Wales can often make arbitrary NHS care funding decisions based on the ability to pay rather than health needs. As a result you may not receive NHS care funding, even if you are eligible.

Many of our clients start working with us after starting to work through the process themselves, but struggle with the complicated system. Working with our team will give you the best chance of securing the correct decision.

There are a number of companies offering this service who do not have our experience and in some cases are not solicitors. A Legal Ombudsman report released in July 2011 revealed that thousands of people may be receiving sub-standard services from unregulated companies offering consumer financial products. Hugh James is regulated by the Solicitors Regulatory Authority (SRA) and complies with the solicitor’s code of conduct.