Our Team Osprey, the CHS Healthcare team managing a large scale caseload of retrospective continuing healthcare claims, have been nominated for an NHS Inspiring Change Award. Based in Stoke, the team is managing up to 1,000 claims for retrospective continuing healthcare funding, lodged with six different clinical commissioning groups. The service has been commissioned by Midlands and Lancashire Commissioning Support Unit and has just been nominated for their staff awards, in the Inspiring Change category.
Retrospective claims for continuing healthcare funding are one of the most critical challenges facing clinical commissioning groups (CCGs). Facing a deadline of March 31, 2017 for the completion of claims, many CCGs lack the resources and specialist expertise to process large numbers of complex cases. We currently provide support for 19 CCGs across the country, assisting different elements of the complex process of retrospective claims management.
Team Osprey provide the first and last parts of the ‘jigsaw’ in claims management: accepting each claim in, requesting and managing all the required information and avoiding delays. They have built excellent relationships with the care homes which hold the care records required for each claim. Building good relationships, including visiting homes to copy records helps to overcome what could otherwise become major obstacles in the process. Information is then chronologically ordered and sent to the CHS Healthcare head office team of case managers. They review the evidence to hand then apply the national framework and upon which, come to a reasoned clinical conclusion.
Once the Care Needs Portrayal document has been completed, Team Osprey again manage the process, communicating with families and solicitors, organising panels/ratifications and communicating the outcome of the claim to the family.
Ros Howard, co-ordinator for Team Osprey, said: “We are really proud of every member of this very hard working, dedicated team. We have a strong partnership with Midlands and Lancashire CSU and this award is a reflection of the strength of that partnership.”
Art Calder, head of Clinical Services for CHS Healthcare commented: “Our first team member, Jody Collier, took up her post in July this year and team recruitment commenced thereafter. For the team to be nominated for a CSU staff award just four months from inception is a fantastic achievement, which reflects how well respected they are, even at this early stage”.
I came up with the name Team Osprey after the first breeding pair of Ospreys were sighted not far from Stoke, in Carsington Water in April 2015. Ospreys are characterised by their keen eye for detail and their ability to fish and hunt. When our team was established soon after this local sighting, the Osprey came to mind, because in order to meet the challenge they would face, the team also needed close attention to detail and the tenacity to hunt down records lodged in different locations.
“From the start, the team have consistently paid great attention to detail and tenacity in tracking down records; living up to their name and meeting the considerable challenge of a very large workload combined with tight deadlines”.