FUNDING DISPUTE RESOLUTION. 10.1 This Clause 10 will only apply to disputes between the Partners regarding:
10.1.1 Funding responsibility for services provided to any Service User who is the responsibility of either or both of the parties under the “ordinary residence” rules or equivalent rules on funding responsibility as they apply to the NHS; or
10.1.2 The outcome of an assessment of needs or eligibility for services to be provided by the ICB under the National Framework for CHC or by the Council; or
10.1.3 The package of services to be offered to a Service User following an assessment;
10.2 The procedure will also cover disagreements between partners over jointly funded care packages.
10.3 There are three stages to this funding dispute resolution process, and these are:
10.3.1 Stage 1: Escalation to Clinical Care Commissioner
10.3.2 Stage 2: Escalation to Chief Nurse for the ICB.
10.3.3 Stage 3: Referral to arbitration.
FUNDING DISPUTE RESOLUTION. 10.1 This Clause 10 will only apply to disputes between the Partners regarding:
10.1.1 Funding responsibility for services provided to any Service User who is the responsibility of either or both of the parties under the “ordinary residence” rules or equivalent rules on funding responsibility as they apply to the NHS; or
10.1.2 The outcome of an assessment of needs or eligibility for services to be provided by the CCG under the National Framework for CHC or by the Council; or
10.1.3 The package of services to be offered to a Service User following an assessment;
10.2 The procedure will also cover disagreements between partners over jointly funded care packages.
10.3 There are three stages to this funding dispute resolution process, and these are:
10.3.1 Stage 1: Escalation to Clinical Care Commissioner
10.3.2 Stage 2: Escalation to Chief Nurse and Director of Quality for the CCG.
10.3.3 Stage 3: Referral to arbitration.
10.4 Stage 1: Escalation to Clinical Care Commissioner: Where any dispute cannot be resolved by the decision-making practitioners, either party may request that the Service Managers (or equivalents) in the Partners' respective decision-making teams meet within 14 days of being notified of the existence of a dispute to review the decision and/or the process by which the decision was made. The purpose of this meeting is to explore the possibility reaching a consensus decision as to the correct outcome of the decision-making process.
10.5 In the case of disputed eligibility for NHS Continuing Healthcare, either Partner may request that the CCG refers the case, if it has not already been considered by that panel, for consideration at the next meeting of its Continuing Healthcare Panel (“CHC panel”). If the case has already been considered by the CHC panel then a request can be made for reconsideration at the next meeting of the CCG’s Continuing Healthcare Review Panel. The Council will always be invited to represent when the case is discussed at the Continuing Care Panel.
FUNDING DISPUTE RESOLUTION. 11.1 This Clause 10 will only apply to disputes between the Partners regarding:
11.1.1 Funding responsibility for services provided to any Service User who is the responsibility of either or both of the parties under the “ordinary residence” rules or equivalent rules on funding responsibility as they apply to the NHS; or
11.1.2 The outcome of an assessment of needs or eligibility for services to be provided by the CCG under the National Framework for CHC or by the Council; or
11.1.3 The package of services, including possibly funded packages, to be offered to a Service User following an assessment;
11.2 The procedure will also cover disagreements between partners over jointly funded care packages.
11.3 There are three stages to this funding dispute resolution process and these are:
11.3.1 Stage 1 – Escalation to Clinical Care Commissioner.
11.3.2 Stage 2 – Escalation to Chief Nurse and Director of Quality for North West London Collaboration of CCGs.
11.3.3 Stage 3 – Referral to arbitration.
