A 92-year-old dying widow’s health care funding has been unjustly taken away from her by health chiefs, an independent review has found.
Alzheimer’s and cancer patient Jean Jarvis had been receiving NHS-funded treatment in a home for seven years when the Croydon Clinical Commissioning Group (CCG) reviewed her notes without assessing her face-to-face.
He decided he no longer met the criteria for funding. She later claimed that this was partly because her limited mobility meant she was easier to “handle”.
Now the health authority has been ordered to reimburse his family £131,000 in care costs, after an appeals panel ruled it should never have to withdraw the funding.
Ms Jarvis, secretary to a retired Cambridge professor, first entered a house in Purley, Croydon, in 2008.
In 2011, she qualified for Continuing Healthcare, a scheme where the NHS pays for out-of-hospital care for any patient who needs help mainly due to a health condition – such as late-stage Alzheimer’s – rather than simply because they have become frail with old age.
Patients who meet the strict criteria are entitled to have their treatment costs paid in full by the health service, without being subjected to income controls.
But The Telegraph previously reported how health authorities are increasingly turning away eligible patients in a bid to fill an £855million hole in budgets.
And in 2019, a Telegraph investigation revealed that more than 7,000 patients eligible for care funding had been re-evaluated and had their funding withdrawn since the cost cut was announced in 2016.
When a Croydon CCG evaluator reviewed Ms Jarvis’s case in January 2018, they decided she was no longer qualified for funding, despite there being no improvement in her progressive condition.
Officials later said this was in part because his behavior was “less problematic because of his immobility and greater frailty”.
His daughter, Gill Snode, said: ‘I went to a meeting and it was clear that no matter what I said, they had decided to take away her funds.
“They didn’t give any real reason why, they just said they didn’t feel she needed it anymore. I think it was just to get the money back.
“It didn’t make any sense because my mother was so much worse. She couldn’t communicate, she had Alzheimer’s and cancer. Someone with Alzheimer’s doesn’t get better and doesn’t get better.
“I couldn’t believe it was happening. They knew nothing about my mother and hadn’t even gone to see her.”
The funding was withdrawn in April 2018 and Ms Snode was forced to use cash from the sale of her mother’s house to pay £6,000 a month for Ms Jarvis’ care until her death in February 2020, aged aged 94.
Ms Snode engaged solicitors Hugh James to support her appeal. In May 2020, officials finally agreed that Ms Jarvis was entitled to treatment between January 30, 2019 and her death. She reimbursed her daughter for the cost of care during that time.
But the GCC still refused to reimburse care costs from April 2018 to January 2019, insisting Ms Jarvis was ineligible for that 10-month period, despite having otherwise met the criteria from 2011 to her death.
NHS ended up paying much more
An independent review panel in November 2020 determined the decision was wrong and found that the CCG had downplayed Ms Jarvis’ needs in a quarter of the categories used to assess eligibility.
Ms Snode finally received her full refund in March of this year, almost two years after her mother’s death.
In total, Croydon CCG repaid £125,000, plus £6,000 interest.
Hugh James’ partner Lisa Morgan said the health authority ended up paying far more than if it had continued to fund Ms Jarvis’s treatment at NHS rates, as it had to reimburse Ms Snode at the higher private rate which was charged to her.
A spokesperson for NHS South West London, who represent Croydon CCG, said: ‘We work hard to deliver the best care for all our residents, working with patients and their families or carers to carry out assessments to carefully consider each individual. Unfortunately it was found that the process fell short of our high standards in this case and we would like to apologize for any concern this may have caused.
“Patients and their families are always welcome to contact us if they have any questions about the evaluations, and there is an opportunity to appeal against the result if they wish.”