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.
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 review process for NHS Continuing Healthcare. It covers the three month review following an eligibility decision, subsequent annual reviews, what a review should and should not cover, the distinction between reviewing the care package and reconsidering eligibility, the risk of funding being withdrawn on the basis of managed stability, and how to prepare.
CHC reviews: the 3-month and annual review
Reviews are routine, but they are also the point at which funding is most often lost. A person who has been stable under a good funded package can be recorded as having reduced needs, when the stability is the package working.
The three month review
A review should take place around three months after an eligibility decision. Its main purpose is to check that the care package is meeting the person's needs, and to confirm that those needs remain as assessed. It is primarily about the adequacy of the package rather than a fresh eligibility exercise.
Annual reviews
After the first review, reviews should take place at least annually. The same principle applies. The focus should be whether the package continues to meet needs, with eligibility reconsidered only where there has been a genuine change in the person's condition rather than as a matter of routine.
Package review versus eligibility review
This distinction matters and is often blurred. Checking that the package fits is not the same as re-running the eligibility decision. Where a review moves into reconsidering eligibility, that should be because needs appear to have changed materially, and a full reassessment using the Decision Support Tool should follow rather than a decision taken at the review itself.
The managed stability trap
This is the central risk. Someone whose behaviour is settled, whose skin is intact and whose weight is stable may appear to have reduced needs, when each of those outcomes is produced by the funded package. The well-managed need principle applies with full force at review, and it is the point to make where withdrawal is being considered.
Preparing for a review
Treat it as you would a first assessment. Gather care records covering the period since funding started, prepare a domain-structured summary describing each need as it would be without the current package, and note any deterioration. Where the package is not meeting needs, say so, since a review is also the opportunity to have it increased.
If withdrawal is proposed
Ask for the reasons in writing, ask whether a full reassessment using the Decision Support Tool has been carried out, and ask for funding to continue while the position is resolved. A withdrawal decision is an eligibility decision, so local resolution and then the NHS England Independent Review Panel are available, with six months running from communication.
Key takeaway
Reviews check whether the package fits, not whether the original decision was right. Prepare as you would for a first assessment, describe needs without the package in place, and treat any proposed withdrawal as an eligibility decision with full appeal rights.
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Frequently asked questions
When should the first review happen?
Around three months after the eligibility decision, mainly to check that the care package is meeting needs. Annual reviews should follow after that.
Can funding be withdrawn at a review?
It can, but only where needs have genuinely changed, and a full reassessment using the Decision Support Tool should follow rather than a decision taken at the review itself. Ask for reasons in writing.
Does improvement under the package count as reduced need?
No. The well-managed need principle applies with full force at review. Stability produced by the funded package is managed need, not resolved need, and the record should show what maintains it.
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.