An Essex woman is helping to campaign for change in the NHS after her mother was forced to sell her home to pay for care.

East Anglian Daily Times: Shirley Lesiak is campaigning for change Picture: SHIRLEY LESIAKShirley Lesiak is campaigning for change Picture: SHIRLEY LESIAK (Image: Archant)

Shirley Lesiak from Colchester is part of a group which is calling for change to the NHS’ Continuing Healthcare funding.

NHS Continuing Healthcare is free social care arranged and funded by the NHS for people with long term, complex health needs.

Mrs Lesiak believed her mother, Lily Capell, should have qualified for the funding.

NHS West Suffolk Clinical Commissioning Group (CCG), which dealt with the case, acknowledged some mistakes were made during the assessment process - but that its original decision has been upheld at all stages of appeal.

East Anglian Daily Times: Lily Capell as a younger woman Picture: SHIRLEY LESIAKLily Capell as a younger woman Picture: SHIRLEY LESIAK (Image: Archant)

Mrs Capell died in 2015 at the age of 92. She had severe Alzheimer’s, atrial fibrillation, heart failure, osteoporosis, mobility problems due to leg oedema and was doubly incontinent.

Despite these conditions, Mrs Capell was deemed ineligible for the continuing healthcare funding when she moved into a retirement home in Sudbury.

At the time of her death, her long-term care had cost around £211,000 - meaning her former family home had to be sold.

Now Mrs Lesiak is hoping to raise awareness around cases like her mother’s as her group, led by Philip Mathias, crowdfunds to have a judicial review opened into the funding.

“We need to have a judicial review,” said Mrs Lesiak, who added that she believes radical reform is needed for what she described as a “disgraceful” system.

A spokesman for NHS West Suffolk Clinical Commissioning Group, which looked after Mrs Capell’s case, said: “There are nationally set eligibility guidelines relating to NHS Continuing Healthcare (NHS CHC) that are strictly adhered to by the clinical commissioning group.

“Eligibility assessments are carried out by a multidisciplinary team (MDT) of health and social care professionals. Mrs Capell had a full NHS CHC assessment and in her case the MDT recommended she was not eligible.

“A retrospective assessment of eligibility for the period from April 1, 2011, to March 5, 2014, was also carried out and again the MDT recommended that Mrs Capell was not eligible for NHS CHC for this period.

“In both cases, the CCG accepted the recommendation of the MDT and decided that Mrs Capell was not eligible for NHS CHC. Mrs Lesiak appealed both the current and retrospective assessments on behalf of Mrs Capell.

“A senior nurse met with her to try and resolve the issue informally, but in the absence of a resolution a full local panel with an independent chair sat to consider her case. On both occasions, the CCG’s original decision was upheld.

“Mrs Lesiak then requested an independent review of the CCG’s decision by NHS England, which upheld our original decision that her mother was not eligible for NHS CHC for both the current and retrospective assessments.

“We acknowledge that some mistakes were made during the assessment process and that Mrs Lesiak was unhappy with the way the MDT meetings were handled.

“The independent review panel commented on this and we have acknowledged that best practice was not adhered to at all times. Our processes have been amended as a result.

“However, our original decision regarding Mrs Capell’s eligibility for NHS CHC has gone through every possible stage of appeal and has been upheld on every occasion.

“We work with local authorities, care homes and other health and care partners to ensure access to the NHS Continuing Healthcare Framework.”

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