22 Armitage Court, Sunninghill, Ascot Berks SL5 9TA

                                                                Tel 01344 620775               robin@nhscare.info

                                                                Ref: TASNHS4. 16th June 2008.


Amanda Walsh, Continuing Care Manager, Hampden Hall, Wendover Rd, Stoke Mandeville, Bucks HP22 5TB.

CC: Maureen Gotara, Nurse Assessor. c/o Amanda Walsh.

CC: Janet Fitzgerald, Chief Executive , Buckinghamshire Primary Care Trust

3rd Floor, Rapid House, 40 Oxford Sreet, High Wycombe, Bucks HP11 2EE.



Dear Amanda Walsh,


Trevor Saunders.


This letter is an appeal against your decision not to grant NHS Continuing Care to Trevor Saunders. Trevor Saunders qualifies for 100% NHS funding (Continuing Care) because his health care needs are the same or greater than Pamela Coughlan; your decision has given an unlawful result.


The reason for your decision not to grant NHS Continuing Care to Trevor Saunders, is that either:

1) errors have been made in your use of your procedures, including the Decision Support Tool, or

2) your procedures are flawed and are producing unlawful results for other patients.


I am sure you are all fully acquainted with the law regarding Continuing Care,  "Coughlan", and the National Framework.  You must know of the statements made on this subject by The Law Society, the Health Ombudsman and the Royal College of Nursing. If not, please visit www.nhscare.info.


You have all been given the required evidence of this. e.g. My letter TASNHS3 dated 1st February 2008 to Janet Fitzgerald which included the Identified Care Needs letter for Trevor, signed by two Registered General Nurses. e.g. My letter TASNHS2 dated 21st January 2008 to Amanda Walsh with this information and the full file. e.g. The similar letter TASNHS1 dated 12th December 2007 to Dr Koshy, which was mislaid by Amersham Hospital.


NHS staff caring for Trevor Saunders have been fully informed of "Coughlan" and www.nhscare.info since early 2007, and the case of Trevor Saunders has now been in the Public Domain since 25th April 2008. Letters such as this will be found on www.nhscare.info/trevor.


Thank you for providing the 30 pages, under covering letter from Maureen Gotara dated 4th June. I welcome the inclusion of my details in the document, and having attended the assessment meeting at Chiltern Court on 10th April. I note the dates at which this assessment document was signed: Maureen Gotara on 10th April 2008 and Jim Peart, Social Worker, on 21st May 2008. I also note the words added by Jim Peart: "I accept the contents of the assessment and the recommendation. However, it is not clear to me if Mr Saunders has given informed consent to Mr Lovelock acting on his behalf in relation to the Continuing NHS Healthcare assessment". Amanda Walsh has the relevant documents in the file regarding this.


There are typographic errors in the covering letter. e.g. "Mrs Trevor Sunders" should be "Mr Trevor Saunders".  I have not returned the last page "Agreement by Non Professionals / Family / Advocates of the above client" because it is inapplicable. It reads, "If you are / are not in agreement with the enclosed Decisions Support Tool". I make no comment on the accuracy of these completed Decisions Support Tool (DST) pages. This appeal is based on your decision giving an unlawful result, not why you came to this decision, including possible use of flawed procedures and/or DST. I am confident that Maureen Gotara and Liz Delaney, who attended the 10th April re-assessment meeting at Chiltern Court, would have taken great care to follow your procedures "to the letter". This is because they were fully briefed on Trevor's case, including "Coughlan", and knew there "would be consequences".


I look forward to the opportunity to attend the Review Panel meeting in response to this appeal. I would appreciate knowing the full names, roles and employers of all members, and the text of any minutes or transcript of the meeting that applies to Trevor's case.


Please do not hesitate to contact me at any time.


                                                                                                                                                                                                Yours Sincerely,



                                                                                                                                                                                                Robin Lovelock