NHS England did not explain why continuing healthcare funding was withdrawn

What happened

Mrs H complained that despite her mother having had continuing healthcare funding since 2007, there was no rational explanation for why that funding was suddenly withdrawn in 2012. This was despite an apparent deterioration in Mrs H's mother's clinical condition.

Mrs H appealed the original decision but it was upheld at the final review, so Mrs H complained to us.

What we found

We partly upheld this complaint. Mrs H's mother did not qualify for continuing healthcare funding at the time funding was withdrawn.

This was because Mrs H's needs were assessed as being purely for social care and assistance with the tasks of daily living. Her health needs had decreased since she was last assessed, and so she was ineligible for funding.

Mrs H did not understand the decision to withdraw the funding because NHS England had not explained to her how her mother's needs were different from those in 2007.

NHS England had not provided evidence that it followed the national guidelines when it considered the withdrawal of continuing healthcare funding.

Putting it right

NHS England provided a written explanation of the actions it had taken to address the apparent oversight we identified.