CHC Appeal Support: Local Resolution

Nellie Supports is an independent social work practice. Our NHS Continuing Healthcare appeal support helps families and professionals in England explain care needs and present relevant evidence.

What appeal support is

Evidence preparation, a written submission and representation at the agreed local resolution meeting.

Local resolution is the ICB's first review stage for a disputed eligibility decision. It provides an opportunity to examine the concerns and supporting evidence.

We organise the case and present the agreed points, helping the person and family participate without having to manage the submission alone.

The submission explains the disputed findings, evidence from the assessment period and any material process concern, then sets out the review requested.

Which domain levels are wrong, and the level the records actually support

Evidence that existed at the time and was not considered

Any gap between what the multidisciplinary team recommended and what was decided

Where the National Framework’s own process was not followed

How the total needs should be considered through the primary health need test

That the appeal was brought within the deadline in the decision letter

We turn concerns into specific questions and supported points. Each disputed domain or process issue should explain what was missed and why it matters.

A clear submission gives the ICB the evidence and questions it needs to reconsider the decision. There is no guaranteed outcome at this stage.

The review concerns the decision at the time it was made, including how the needs and assessment process were considered under the National Framework.

We use contemporaneous evidence to examine the domain levels and the total needs. Later changes are kept separate so any need for fresh assessment can be addressed.

National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care; ICB local resolution arrangements and the relevant review deadline.

Read the supporting guidance

Nature of the person's needs

Intensity of the person's needs

Complexity of the person's needs

Unpredictability of the person's needs

Everything in the submission is traceable to a document or a first-hand account.

The decision and the DST

The scoring under challenge, domain by domain.

The care records

Daily notes, charts and incident records across the period.

The needs assessment and care plan

The independent account of what the person needs.

Clinical input

GP, community nursing, SALT and specialist evidence.

Correspondence with the ICB

What was asked for, what was provided and what was ignored.

Process history

Dates, notice, attendance and whether the framework was followed.

A family believes a CHC refusal missed fluctuating needs and wants support with local resolution.

In this example, we would review the records for the disputed period, identify supported points and present the written case at the agreed meeting.

The ICB would make its review decision. We would explain the outcome and any further review option.

The family would have a reasoned submission and someone to help explain it, without a promise about the funding result.

Illustrative example only. This does not describe a client or predict an NHS or Ombudsman decision.

We agree a clear instruction and reporting arrangements before starting work.

Scope confirmed in writing

The stage, the fee and the timescale are confirmed in writing before instruction.

Evidence in the language of the framework

Needs are described against the twelve care domains and the four key characteristics, not in general terms.

Evidence and reasons explained

The written work identifies the records used, the reasons for our view and any gaps that could affect it.

A reasoned next step

We explain where the evidence does not support further work and what other route may be relevant.

Registered professionals who prepare the evidence and then stand behind it in the room.

For families

You have someone to explain the process, organise the relevant evidence and help you put the person's needs into words. The work and fee are agreed before we start.

For professionals

We agree the instruction, authority to act, evidence required, reporting arrangements and timetable with you. Written work links each point to its source.

Tell us the decision and DST dates, the deadline in the letter and any review already requested. We will confirm the appropriate service, scope and fee in writing.

Tell us about any urgent date at first contact so we can confirm whether the required timetable can be met.

Support for previously unassessed periods, starting with a £594 including VAT qualification review including VAT, credited against the full service if you proceed.

Practice leadership: Ben Slater, Founder and Managing Director, Nellie Supports. Read our editorial policy.

The Nellie Standard is our own framework for clear, evidence-led assessment and advocacy.

For CHC Appeal Support, we identify the question, the relevant period and the evidence needed before forming a view.

The work considers negative eligibility decisions, appeal grounds, disputed domain levels, procedural concerns and the evidence needed to challenge or clarify the decision. The written scope identifies the records and analysis included.

Our written conclusions explain the evidence, reasoning and limits of the position advanced. The NHS or relevant review body makes its own decision.

Evidence before opinion. Correct framework first. Appeal analysis. Transparent reasoning. Clear conclusions. Capable of scrutiny.

For CHC Appeal Viability Review, we identify the question, the relevant period and the evidence needed before forming a view.

The work considers the evidential strength of a potential appeal, including domain scoring, rationale, missing records, process issues and proportionality of proceeding. The written scope identifies the records and analysis included.

Evidence before opinion. Correct framework first. Appeal viability analysis. Transparent reasoning. Clear conclusions. Capable of scrutiny.

For CHC Refusal Appeal, we identify the question, the relevant period and the evidence needed before forming a view.

The work considers refusal decisions, reasons for non-eligibility, disputed findings, record evidence and whether the decision properly reflects the person’s needs. The written scope identifies the records and analysis included.

For Local Resolution CHC Appeal Support, we identify the question, the relevant period and the evidence needed before forming a view.

The work considers local resolution submissions, disputed rationale, evidential gaps, procedural fairness and the link between records and the CHC eligibility decision. The written scope identifies the records and analysis included.