NHS Continuing Healthcare
CHC Appeal Support: Challenge a Continuing Healthcare Refusal
Structured, evidence led support through local resolution and the Independent Review Panel
CHC appeal support helps a family challenge an NHS Continuing Healthcare eligibility decision. There is a six month window to challenge a decision. A registered social worker reviews the care records and the Decision Support Tool, prepares a structured written submission for local resolution with the Integrated Care Board, and can prepare and represent the case at the NHS England Independent Review Panel if local resolution does not resolve it.
From £2,250
Fixed fee, plus VAT, stated before instruction
One working day
Enquiry triage response
England
Wales runs a separate Continuing NHS Healthcare framework
Social work led
Registered social workers, peer reviewed
Nellie Supports is England and Wales' largest identified specialist private social work and mental capacity assessment practice, operating through a permanent, full-time employed team that has completed more than 11,000 assessments. Our NHS Continuing Healthcare appeal support is social work led: we prepare and present the evidence of need. We are not a law firm and not a claims company.
When you may need appeal support
A decision that a person is not eligible can be challenged within six months. The first stage, local resolution, is handled by the Integrated Care Board that made the decision. Many families attempt this stage alone, without the records analysis that gives a challenge substance.
Beyond local resolution sits the NHS England Independent Review Panel, and beyond the panel the Parliamentary and Health Service Ombudsman. An appeal succeeds on evidence and procedure, not on strength of feeling, so the work is in the records.
What an appeal actually tests
The question on appeal is whether the person's overall needs meet the primary health need test under the National Framework, and whether the process that produced the decision followed the Framework correctly.
A primary health need is judged by the nature, intensity, complexity and unpredictability of the person's needs. The appeal examines how the Decision Support Tool scored those needs against the evidence in the records.
Nature of the person's needs
Intensity of the person's needs
Complexity of the person's needs
Unpredictability of the person's needs
Framework: National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (2022 revision); local resolution and NHS England Independent Review Panel procedure; Parliamentary and Health Service Ombudsman
For more, read our guide: The NHS Continuing Healthcare process explained
Acting as a professional deputy or attorney? Read: Re ACC and CHC appeals: what the ruling means for professional deputies
Our support process
Initial enquiry and triage
Send us the decision letter. We gather the key details and respond within one working day.
Honest viability first
We review the decision letter and the Decision Support Tool and tell you plainly whether the records support a challenge before you spend more.
Records analysis and submission
A registered social worker analyses the full care records against the DST scoring and prepares a structured written submission to the Integrated Care Board for local resolution.
Panel preparation and representation
If local resolution does not resolve it, we prepare the case for the NHS England Independent Review Panel and represent you at it.
After the panel
We explain the outcome and, where procedure has not been followed, the remaining route to the Parliamentary and Health Service Ombudsman.
What you receive
Appeal support is records based and honest about prospects. Depending on the stage, you receive:
An honest written view on whether the records support a challenge
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A full analysis of the care records against the DST scoring
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A structured written submission for local resolution
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Preparation of the case for the Independent Review Panel
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Representation at the panel
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A written outcome summary and next steps
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Fees
From £2,250 plus VAT
Appeal application drafting and submission £2,250 plus VAT. Local resolution submission and attendance £2,750 plus VAT. Independent Review Panel application and attendance £6,250 plus VAT. Travel for in-person attendance is confirmed in writing before booking.
Travel for in-person attendance is confirmed in writing before booking.
Honest viability view
A frank written view on the evidence before you commit.
Full records analysis
The care records read against the DST scoring, line by line.
Structured written submission
Local resolution done properly, in writing, to the ICB.
Panel representation
Preparation and representation at the Independent Review Panel.
Peer review as standard
A second qualified professional reviews every submission.
No percentage fees
Fixed fees only. We take no share of any backdated funding.
How a CHC appeal works in practice
A family came to us four months after a not eligible letter, with two months of the six month window left and a strong sense that something had gone wrong. The first thing we did was tell them we did not yet know whether they had a case.
A registered social worker obtained the completed Decision Support Tool and the full care records and compared them line by line. Three domains had been scored on the person's stable days, while the records themselves described weekly crises, and the family's own account of the nights had never been recorded at all. That gap, between what the records showed and what the tool said, became the substance of the local resolution submission. We put it in writing, domain by domain, and represented the family at the meeting that followed.
The Integrated Care Board makes the decision. Our job was to make sure it was made on the evidence that existed all along.
This is an illustrative example. It does not describe any individual client.
Why families and professionals choose Nellie Supports
Honest viability before commitment
We tell you if the records do not support a challenge. A weak case costs a family money and hope, and we will not take one forward quietly.
Records based, not rhetoric based
Appeals succeed on evidence and procedure. The work is in the records, and that is where we do it.
Social work led, no percentage fees
Fixed fees, VAT included, published before instruction. We take no share of any backdated funding.
A permanent employed team
A full-time, in-house multidisciplinary team with more than 11,000 assessments completed practice-wide.
Peer reviewed as standard
Every submission is reviewed by a second qualified professional before it goes to the ICB or the panel.
We know the assessment from the inside
Our assessors write professional assessments for a living, so we read a Decision Support Tool the way its authors do.
Frequently Asked Questions About CHC Appeals
How long do we have to challenge a decision?
There is a six month window to challenge an eligibility decision, running from the date of the decision letter. If you are close to the edge of that window, contact us promptly and say so, because a well-prepared request submitted in time protects your position while the full submission is developed. Out-of-time requests can be refused outright.
What is local resolution?
Local resolution is the first stage of challenge, handled by the Integrated Care Board that made the original decision. It is where a well-evidenced written submission does its work, because the ICB reviews its own decision against the National Framework and the evidence you present. Challenges can be resolved at this stage without going further.
What is the Independent Review Panel?
The Independent Review Panel is convened by NHS England to review whether the Integrated Care Board followed proper procedure and applied the National Framework correctly. It is not a rehearing of the whole case from scratch, which is why the quality of the written submission and the accuracy of the evidence presented at earlier stages matter so much.
What are our chances of success?
We do not quote success rates, because every case turns on its own records and no honest provider can promise an outcome. What we will give you is a frank written view of your evidence before you commit to either stage, including where the decision looks sound. That honesty costs us some instructions, and it is the only defensible way to work.
What if the panel does not change the decision?
Beyond the Independent Review Panel sits the Parliamentary and Health Service Ombudsman, which looks at maladministration and procedural failure rather than re-deciding eligibility. We will tell you honestly whether that route has substance in your case, because pursuing an Ombudsman complaint without a genuine procedural failing wastes time and prolongs a difficult process for the family.
Related NHS Continuing Healthcare guides
Challenging a CHC decision
CHC eligibility and primary health need
The Independent Review Panel explained
The Ombudsman and CHC complaints
Re ACC and CHC appeals: guidance for professional deputies
Other CHC support stages
If your situation is at a different stage, our team supports the full NHS Continuing Healthcare pathway.
CHC Assessment Support
Fast Track Review Advocacy
Retrospective CHC Claims
Nellie Supports provides independent social work assessment, evidence and advocacy support. We do not provide regulated legal advice, and where a legal remedy is needed we will say so and support your solicitor's work.
Has funding been refused?
Contact Nellie Supports to discuss the decision letter and the six month window. We will tell you honestly whether the records support a challenge before you commit to one.
We aim to respond to all enquiries the same working day.
Written by Ben Slater, Founder and Managing Director, Nellie Supports. Read our editorial policy.