A dying 92-year-old widow’s care funding was wrongly stripped away from her by health chiefs, an independent review has found.
Alzheimer’s and cancer patient Jean Jarvis had been receiving NHS-funded care in a home for seven years when Croydon Clinical Commissioning Group (CCG) reviewed her notes without assessing her face-to-face.
It decided she no longer met the criteria for funding. It later claimed this was partly because her decreased mobility meant she was easier to “manage”.
Now the health authority has been ordered to repay her family £131,000 in care fees, after an appeal panel found it should never have withdrawn the funding.
Mrs Jarvis, a retired professor’s secretary from Cambridge, first went into a home in Purley, Croydon, in 2008.
In 2011, she qualified for Continuing Healthcare, a scheme where the NHS pays for care outside of hospital for any patient who needs help primarily because of a health condition - such as later stage Alzheimer’s - rather than simply because they have become frail through old age.
Patients who meet the strict criteria are entitled to have their care fees fully paid by the health service, without being means tested.
But The Telegraph has previously reported how health authorities are increasingly turning down eligible patients in a bid to plug an £855 million hole in budgets.
And in 2019, a Telegraph investigation revealed how more than 7,000 patients who were eligible for care funding had been reassessed and had their funding revoked since the cost-cutting drive was announced in 2016.
When a Croydon CCG assessor re-examined Mrs Jarvis’s case in January 2018, they decided she no longer qualified for funding, despite there being no improvement in her progressive condition.
Officials later claimed this was partly because her behaviour was “less problematic as a result of her immobility and increased frailty”.
Her daughter, Gill Snode, said: “I went into a meeting and it was clear that it didn’t matter what I said, they had decided to take her funding away.
“They didn’t give any real reasons why, they just said they didn’t feel she required it any more. I think it was just to claw money back.
“It didn’t make any sense because my mum was much worse. She couldn’t communicate, she had Alzheimer’s and cancer. Somebody with Alzheimer’s doesn’t improve and get better.
“I couldn’t believe it was happening. They knew nothing about my mum and they hadn’t even gone to see her.”
The funding was withdrawn in April 2018 and Mrs Snode was forced to use cash from the sale of her mother’s house to pay £6,000 per month for Mrs Jarvis’s care until she died in Feb 2020, aged 94.
Mrs Snode instructed solicitors Hugh James to help her appeal. In May 2020, officials eventually agreed that Mrs Jarvis had been entitled to care between Jan 30 2019 and her death. It repaid her daughter for the cost of care during that time.
But the CCG still refused to refund the care bills from April 2018 to Jan 2019, insisting Mrs Jarvis had not been eligible for that 10-month period, despite her having otherwise met the criteria from 2011 to her death.
NHS ended up paying out far more
An independent review panel in Nov 2020 ruled that decision was wrong and found the CCG had downplayed Mrs Jarvis’s needs in a quarter of the categories used to assess eligibility.
Mrs Snode finally received the full refund in March this year, nearly two years after her mother had died.
In total, Croydon CCG paid back £125,000, plus interest of £6,000.
Lisa Morgan, a partner at Hugh James, said the health authority had ended up paying out far more than if it had continued to fund Mrs Jarvis’s care at NHS rates, as it had to reimburse Mrs Snode at the higher private rate she was charged.
A spokesman for the NHS in South West London, which represents Croydon CCG, said: “We work hard to offer the best care for all our residents, working with patients and their family or carers to carry out assessments to carefully consider each individual. Unfortunately it has been found that the process was not up to our high standards in this case and we would like to apologise for any concern caused.
“Patients and their families are always welcome to contact us if they have any questions about assessments and there is an opportunity to appeal the outcome if they choose."