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. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
3. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
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.
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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 how to request a reassessment for NHS Continuing Healthcare following a change in a person's condition. It covers when a reassessment is more appropriate than an appeal, what counts as a relevant change, how to make the request, what evidence supports it, the position where a previous assessment was unsuccessful, and what happens next.
Requesting a CHC reassessment after a change in condition
Where a person's condition has changed, requesting a fresh assessment is often faster and more productive than challenging an old decision. A reassessment looks at what is true now rather than arguing about what was true months ago.
Reassessment or appeal
The choice depends on what you are saying. If the earlier decision was wrong on the evidence available at the time, that is an appeal. If the person's needs have since increased, that is a reassessment. Appeals revisit reasoning and take months. Reassessments look at the current picture and are usually quicker, and they avoid arguing about a historical position.
What counts as a change
A deterioration in condition, a new diagnosis, a significant clinical event such as a stroke or fall, a hospital admission, the introduction of a new clinical intervention, a marked increase in the care package, or repeated placement difficulty. The change should be describable and datable rather than a general sense that things are worse.
How to make the request
Write to the Integrated Care Board's continuing healthcare team. State that you are requesting a reassessment, describe what has changed and when, and refer to the supporting evidence. Where the previous decision is recent, explain specifically what is different now, since that is the question the Board will ask first.
Evidence that supports it
Records covering the period since the last assessment are what matter. Hospital discharge summaries, new clinical letters, updated care plans showing increased provision, incident and falls logs, weight records showing loss, new assessments from speech and language therapy or tissue viability, and any record of a change in staffing levels.
Where the last assessment was unsuccessful
A previous refusal does not prevent a fresh assessment where circumstances have changed. It does mean the request needs to be clear about the change, since a Board receiving what looks like a repeat request without new circumstances is unlikely to act quickly. Lead with what is different, not with disagreement about the earlier outcome.
What happens next
Depending on the circumstances the Board may arrange a fresh Checklist or move directly to a full assessment. Either way, prepare as you would for a first assessment, with a domain-structured summary describing needs as they would be without the current care in place, and with records gathered in advance.
Key takeaway
Reassessment addresses what is true now, appeal addresses whether the old decision was right. Where the person has deteriorated, request a reassessment, describe the change with dates, and lead with the evidence that has arisen since the last assessment.
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Frequently asked questions
Should we reassess or appeal?
Reassess where needs have increased since the last decision. Appeal where the earlier decision was wrong on the evidence available at the time. Reassessment is usually quicker and avoids arguing about a historical position.
How soon can we request another assessment?
There is no fixed waiting period. What matters is that there has been a relevant change in condition or circumstances, described with dates and supported by evidence arising since the last assessment.
What counts as a relevant change?
Deterioration, a new diagnosis, a significant clinical event, a hospital admission, a new clinical intervention, a marked increase in the care package, or repeated placement difficulty.
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.