Overview
The complainant (Mr C) raised a number of concerns that, following his father (Mr A)'s stroke in November 2004, his father became eligible for NHS funding of all his care in a Nursing Home rather than the limited funding he received from his local authority. Ayrshire and Arran NHS Board (the Board) had not agreed to fund this care and Mr C raised a complaint that the matter had not been properly considered.
Specific complaints and conclusions
The complaints which have been investigated are that the Board failed to:
- (a) properly assess Mr A's eligibility for NHS funded Continuing Care (upheld); and
- (b) properly review Mr C's application for NHS funded Continuing Care (partially upheld).
Redress and recommendations
The Ombudsman recommends that the Board:
- (i) undertake a retrospective, evidenced assessment of Mr A's continuing care needs and;
- (ii)ensure that where there is an application either for NHS Continuing Care Funding or to review a decision to refuse funding, the process for dealing with that application is explained to the applicant at the outset.
The Board have accepted the recommendations and agreed to act on them accordingly.