Author and Publication
Author: Ben Slater, Registered Social Worker, Founder and Managing Director of Nellie Supports
Reviewed by: Kerry Slater, Director of Operations
Last reviewed: 20 July 2026
Citation
1. Department of Health and Social Care (2022) National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Available at: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
2. Parliamentary and Health Service Ombudsman. Making a complaint about the NHS in England. Available at: https://www.ombudsman.org.uk
3. R (Grogan) v Bexley NHS Care Trust and others [2006] EWHC 44 (Admin).
4. Mental Capacity Act 2005, c. 9. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
This article is made available for general information, education and professional reference. It may be downloaded, printed and shared for non-commercial purposes, provided that it is reproduced in full, is not altered in any way, and is properly cited as the work of Nellie Supports Ltd. This material must not be edited, adapted, sold, republished, incorporated into commercial products, or used for commercial training, assessment, report-writing or advisory services without prior written permission from Nellie Supports Ltd.
This article does not constitute legal advice, clinical advice or a substitute for a decision-specific professional assessment. Where legislation, government guidance, court forms or external professional materials are referred to, those materials remain subject to their own copyright, licensing and re-use terms.
Abstract
This guide explains whether an NHS Continuing Healthcare decision that was previously accepted can be challenged later. It covers why acceptance does not bar a challenge, the effect of time limits, requesting discretion, when a fresh assessment is the better route, the position on backdating, and what to do where circumstances or understanding have changed.
Appealing after a CHC decision has been accepted
Families frequently accept a decision because they did not know it could be challenged, or because they had no capacity to fight it at the time. Accepting a decision does not sign away the right to question it later.
Acceptance is not a bar
There is no rule that accepting a decision prevents a later challenge. People accept decisions for all sorts of reasons: exhaustion, bereavement, not being told there was a route, or being told incorrectly that the outcome was final. None of those remove the ability to ask for the decision to be reviewed.
Time is the real obstacle
The practical difficulty is the six month expectation for requesting local resolution, running from when the decision was communicated. Where that has passed, you are asking the Board to exercise discretion. That is worth doing, but it needs an explanation, and the explanation carries more weight than the strength of the underlying case at that stage.
Explaining the delay
Good reasons include not having been given the completed Decision Support Tool, not having been told of the right to seek a review, illness or bereavement, a period during which the person lacked capacity and had no representative, or having received incorrect information about finality. State the reason plainly and briefly, without embellishment.
Consider a fresh assessment instead
Where the person's needs have changed since, requesting a reassessment is usually faster and more productive than reopening an old decision. It looks at what is true now rather than arguing about a historical position, and it does not depend on discretion being exercised. It does not, however, recover the intervening period financially.
Backdating and the intervening period
If the concern is money already paid, a fresh assessment will not address it, since it looks forward. Recovering the period requires the original decision to be revisited, or the matter pursued as a retrospective claim, which operates under separate arrangements with different cut-off dates. Be clear at the outset which of the two you are pursuing.
If discretion is refused
Ask for the refusal and its reasons in writing. Where the delay was caused by the Board's own failure, for example not providing the paperwork or not explaining the review route, that is a complaint in itself and can be pursued through the complaints process and ultimately the Ombudsman.
Key takeaway
Accepting a decision does not prevent a later challenge, but time does complicate it. Ask for discretion with a plain explanation of the delay, and decide early whether you are pursuing the current position through reassessment or the past period through the original decision.
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Frequently asked questions
Does accepting a decision waive our rights?
No. There is no rule that acceptance bars a later challenge. People accept decisions for many reasons, including not being told a review route existed, and none of those remove the ability to question it.
What if the six months has passed?
You are asking the Board to exercise discretion, which is worth doing. Explain the delay plainly, particularly where it was caused by not receiving the paperwork or not being told of the review route.
Is a fresh assessment easier?
Usually, where needs have changed, because it looks at the current position rather than depending on discretion. It will not, however, recover any money already paid for the intervening period.
Related NHS Continuing Healthcare pages
These links take you to the most relevant Nellie Supports service page and to the supporting guides that explain the surrounding process.
Speak to an independent CHC specialist
Nellie Supports prepares independent needs evidence for NHS Continuing Healthcare assessments, reviews and appeals across England and Wales. Our reports are written by registered social workers on a permanent employed team, with internal peer review before release. Call 0333 987 5118 or send an enquiry and we will talk through where you are in the process.