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. Social Work England. Professional standards. Available at: https://www.socialworkengland.org.uk
3. Solicitors Regulation Authority. Available at: https://www.sra.org.uk
4. Parliamentary and Health Service Ombudsman. Available at: https://www.ombudsman.org.uk
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 how to run an NHS Continuing Healthcare appeal without paid support. It covers the documents to obtain, the method for reviewing them, how to structure a submission, how to conduct yourself at local resolution and at panel, the realistic time commitment involved, and the circumstances in which paid support tends to make a difference.
Running a CHC appeal yourself
Plenty of families run NHS Continuing Healthcare appeals themselves and succeed. The process is designed to be navigable without representation, and the method matters far more than who is applying it.
Get the documents
Request the completed Decision Support Tool, the multidisciplinary team recommendation, the written decision with reasons, and the care records for the same period. Ask in writing. You cannot run an appeal on a decision letter alone, and requesting the full paperwork is the first thing to do rather than the last.
Note the deadline immediately
The expectation is six months from the date the decision was communicated to request local resolution. Diarise it as soon as the decision arrives. Where the paperwork is slow to come, request local resolution within the period anyway and say the detailed grounds will follow.
Review the tool with a method
Work domain by domain. Read each narrative, form your own view, then look at the level recorded. Note every difference. Then check every domain for well-managed need, by asking whether the narrative describes the need or the outcome of good care. Then look for what is absent, particularly night time needs and fluctuation.
Structure the submission
A numbered list, not a narrative. For each domain: the level recorded, the level you say applies, why, and the evidence with dates. Then a separate section on nature, intensity, complexity and unpredictability. Then a separate section on any procedural failures. Two to four pages over a paginated bundle.
At the meeting and at panel
Lead with your strongest two or three points. Use concrete dated examples rather than general statements. Ask for your points to be recorded, including where the team disagrees. Take notes of who said what. Ask for written confirmation of the outcome and of when local resolution has concluded.
Be realistic about the commitment
The records review is the demanding part and can run to several hundred pages. Expect the whole process to take many months, sometimes more than a year through to panel. That is manageable but it is worth knowing at the outset, particularly if you are also providing care.
When paid support tends to help
Where the records are extensive and you cannot get through them. Where the clinical picture is complex and needs professional interpretation. Where you have already been through local resolution unsuccessfully. Where the personal cost of doing it yourself, particularly after a bereavement, is too high. Those are the situations where it changes things.
Key takeaway
Get the full paperwork, diarise the deadline, review domain by domain testing for well-managed need, and submit a numbered list with dated evidence. The method is what wins, and it is entirely possible to apply it yourself.
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Frequently asked questions
Can we really do this ourselves?
Yes. Many families do and succeed. The process is administrative rather than legal, panels are used to hearing from families, and the method matters more than who applies it.
What is the first thing to do?
Request the completed Decision Support Tool, the recommendation, the decision with reasons and the care records, in writing. Then diarise the six month deadline from the date the decision was communicated.
How should the submission be structured?
As a numbered list by domain, each with the level recorded, the level you say applies and the evidence with dates, plus separate sections on the four key characteristics and any procedural failures.
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.