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. R (Grogan) v Bexley NHS Care Trust and others [2006] EWHC 44 (Admin).
3. Parliamentary and Health Service Ombudsman. Making a complaint about the NHS in England. Available at: https://www.ombudsman.org.uk
4. R v North and East Devon Health Authority, ex parte Coughlan [2000] 2 WLR 622.
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 the local resolution stage of the NHS Continuing Healthcare appeals process. It covers how to request it, what the Integrated Care Board does at this stage, who attends a local resolution meeting, the possible outcomes, how long it typically takes, and how to move the matter to NHS England for an Independent Review Panel where it remains unresolved.
CHC local resolution: what to expect
Local resolution is the first formal stage of challenging an NHS Continuing Healthcare decision, and it resolves a meaningful proportion of disputes. It is run by the Integrated Care Board that made the decision, which is both its main limitation and the reason it can move quickly.
What local resolution is
It is the Integrated Care Board's own review of its eligibility decision. The Framework expects Boards to have a local process for handling disagreements before a matter is referred to NHS England. It is not an independent stage, since the Board is reviewing itself, but it is the required first step and it does resolve a significant number of cases without further escalation.
How to request it
Write to the Board's continuing healthcare team within six months of the decision being communicated. State the decision date, that you are requesting local resolution, and the grounds in outline. Ask at the same time for the completed Decision Support Tool, the multidisciplinary team recommendation and the written reasons for the decision, if you do not already hold them.
What the Board does
Practice varies. Some Boards conduct a paper review, some convene a panel, and some hold a meeting with the family. The review should consider whether the assessment was carried out properly, whether the domain levels are supported by the evidence, and whether the primary health need test was correctly applied. It should not simply restate the original conclusion.
Who attends a meeting
Where a meeting is held, it usually involves a Board representative, often a continuing healthcare nurse or manager, sometimes a member of the original multidisciplinary team, and the person or their representative. You can bring someone with you. Ask in advance who will attend and in what capacity, so you know whether the people present were involved in the original decision.
Preparing for it
Work from the paperwork. Identify the specific domains where the recorded level does not match the narrative, the reasoning steps that are missing, and the evidence that was not considered. Set the points out in writing beforehand and send them in advance. A structured two or three page submission is considerably more effective than raising points for the first time in the room.
Possible outcomes
The Board may uphold the original decision, overturn it and find the person eligible, or decide that the assessment was defective and arrange for it to be redone. That third outcome is common and worth understanding, because a fresh assessment is not a refusal, it is an opportunity to get the evidence right with the benefit of everything learned so far.
Timescales
There is no fixed statutory timescale, and local resolution frequently takes several months. Ask for an expected timescale at the outset and for written confirmation when the stage has concluded, since the six month period for referring to NHS England runs from that point and Boards do not always make the end date clear.
If it does not resolve matters
Request an Independent Review Panel through NHS England within six months of the conclusion of local resolution. The panel is independent of the Board, which is its main advantage. Keep the written record from local resolution, since the panel will want to see what was argued and how the Board responded.
Key takeaway
Local resolution is the Board reviewing its own decision and is the required first step. Request it in writing within six months, submit structured written grounds in advance, and get written confirmation when the stage concludes so the next deadline is clear.
Frequently asked questions
Is local resolution independent?
No. It is the Integrated Care Board reviewing its own decision. Independence comes at the next stage, the NHS England Independent Review Panel, which is why the written record from local resolution matters.
How long does it take?
There is no fixed timescale and several months is common. Ask for an expected timescale at the outset and for written confirmation when the stage has concluded, since the next deadline runs from that point.
Do I have to attend a meeting?
Not always, as practice varies and some Boards conduct a paper review. Where a meeting is offered it is usually worth attending, and you can bring someone with you.
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.