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Continuing Healthcare Reviews

The Coughlan Case

In 1971 Pamela Couglan was seriously injured in a road accident. She received care from the NHS in Newport Hospital until 1993. It was then that the Exeter Health Authority wanted to move her to a new home.

 

Pamela Coughlan and others were promised that Mardon House would be their home for life. However, in October 1998 the Health Authority decided to withdraw services from Mardon House, close it, and transfer the care of Miss Coughlan and the other disabled individuals to LA Social Services.

 

In 1999 Pamela Coughlan was denied fully funded NHS care. She was told it was because she only needed general nursing, not specialist nursing. Pamela argued that the NHS had wrongly transferred responsibility onto the social services. The Court of Appeal agreed and Pamela won her case.

The Grogan Case

In 2005 chronically ill Maurenn Grogan successfully challenged a decision by Bexley NHS Trust who denied her fully funded NHS care.

 

Maureen Grogan was chronically ill with multiple sclerosis and additional health needs, including dependant oedema and the asociated risks of ulcers along with double incontence. She had no mobility and was a wheelchair user who was exeriencing cognitive impairment. She was in a nursing home and she had to sell her house to pay for Care.

 

The NHS had assessed her three times as "ineligible" for NHS Continuing Healthcare, even though the assessments showed she had substantial health needs. After deciding that she was not entitled to fully-funded NHS care, she was assessed as having substantial nursing needs and the NHS therefore made a contribution to her nursing care (up to £125 per week). She was forced to sell her home to cover the care fees.  

 

In January 2006 she won her case against Bexley NHS Trust. The judgement in the  High Court for England and Wales showed that the criteria used by the NHS in their Care Funding decision had been "fatally flawed" and that Maureen Grogan should not have paid for her own care.

Case Law

The Court of Appeal stated:

 

"If the person's reason for placement in the home was primarily a health need then the NHS is responsible for funding the whole package."

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