THE family of a Wigan pensioner have finally been refunded £117,000 for wrongly paid nursing home fees - just days before she died.
It was with the most appallingly tragic timing that an eight-year battle for justice was finally won by Evangeline McConnell and her loved ones.
The 88-year-old former nurse had been forced to sell her home to pay for nursing fees after the NHS judged that she had “no health needs.”
This despite her suffering a “catastrophic” stroke in 2003 which had left her immobile, incontinent, unable to communicate and swallow. She was totally reliant on two to three carers to attend to all her needs and a tube was placed in her stomach to provide her with nutrition and medication.
When Mrs McConnell suffered the stroke in October 2002 she was admitted to Wigan Infirmary and then spent six months Leigh Infirmary for rehabilitation. However, her family were informed that she could not return home as she still needed 24-hour nursing care.
Mrs McConnell was then admitted to the Arncliffe Court Nursing Home in Halewood, Liverpool and later St Bartholomews Court Nursing Home in Huyton where she died on November 3.
The family had been told that due to Mrs McConnell’s capital and income, she would have to pay for her own nursing care costs.
Son Phil asked the NHS for an assessment before she was discharged from hospital in 2003. However, the NHS said she was stable and not complex and therefore not eligible for exemption. This meant she became the responsibility of the social services and because of her assets, had to sell her home to pay for her nursing care fees of £2,000 per month.
Mr McConnell said: “The only reason my mother needed to go into a nursing home was because she was very ill and required 24-hour nursing care.
“I was aware of NHS Continuing Healthcare and asked the hospital to assess my mother. I was shocked when they said she did not meet the criteria. I appealed the decision as I felt it was clear that my mother should have had her fees paid by the NHS. In 2004, I was told I had lost my appeal. I was very upset and angry and felt that the system was so complex and unfair that I gave up.”
Continuing healthcare is where the NHS is responsible for, and fully funds care - it mainly affects very ill patients, often elderly, in nursing homes; but can also apply if a person is in hospital long term or needs nursing care at home.
Despite regular assessments, it was not until January 2008 that Mrs McConnell was assessed as meeting the criteria and all her future fees were to be paid by the NHS.
Mr McConnell said: “I was very pleased when the NHS finally accepted that my mother was eligible for NHS Continuing Healthcare. It was however obvious to me that her needs had not changed and she should have always been their responsibility.
“The system is so complex but I was determined to challenge their previous decision. They put so many obstacles in our way and I would have given up without assistance. It has been a hard and long fight, but I am happy that the NHS have finally admitted that they should have been responsible for my mum’s nursing home fees and have reimbursed her all the money.”
Lisa Morgan, partner at law firm Hugh James acts for the Mrs McConnell and her family and said: “If the NHS had made the correct decision in 2003, the distress and heartache to the family could have been avoided.”
A Department of Health spokesmn said: “PCTs have a legal duty to ensure that continuing healthcare (CHC) decisions follow the National Framework published by the Department. A record number of people are now in receipt of CHC, the number has increase by 92% since the introduction of the Framework in 2007. The NHS has reviewed 12,000 retrospective cases to ensure that past CHC decisions were compliant with the law.”