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 NHS England Independent Review Panel stage of the NHS Continuing Healthcare appeals process. It covers when a referral can be made, what the panel is, who sits on it, what it can and cannot decide, how long the process takes, how to prepare a submission, and what options remain if the panel does not find in your favour.
The NHS England Independent Review Panel explained
The Independent Review Panel is the first genuinely independent stage of the NHS Continuing Healthcare appeals process. It sits outside the Integrated Care Board that made the decision, and that independence is its central value.
When you can refer
A referral to NHS England can be made once local resolution has concluded without resolving the dispute, normally within six months of that conclusion. NHS England will generally expect local resolution to have been completed first, so a referral made before that stage has run is likely to be sent back. Where the Board has been unable or unwilling to conclude local resolution, say so in the referral.
What the panel is
It is a panel convened by NHS England, independent of the Board whose decision is under review. It is advisory in form, in that it makes a recommendation to the Board, but in practice its recommendations are followed and departing from one would require a great deal of justification. It considers both whether the process was properly followed and whether the eligibility conclusion was right.
Who sits on it
A panel typically includes an independent chair, a clinical member and a member with social care experience, none of whom were involved in the original decision. A representative of the Board attends to explain its decision, and the person or their representative attends to put their case. The composition is intended to mirror the disciplines involved in the original assessment.
What it can and cannot do
It can recommend that the eligibility decision be overturned, that it be upheld, or that the assessment be redone. It cannot award damages, address complaints about staff conduct, or deal with matters outside the eligibility question. Where the concern is really about how the family was treated rather than about eligibility, the complaints route and the Ombudsman are the correct destination.
How long it takes
The process commonly takes several months from referral to hearing, and longer where records must be gathered from multiple sources. NHS England should confirm receipt of the referral and give an indication of timescale. Delay at this stage is frequent, and the same approach applies as elsewhere, which is a written chronology and periodic written chasing.
Preparing a submission
Written preparation carries more weight here than anywhere else in the process. Set out the decision under review, the grounds, and the evidence for each ground, organised domain by domain and with dated references. Address the four key characteristics explicitly. Where the Board departed from a multidisciplinary team recommendation, deal with that as a separate procedural ground.
At the hearing
Hearings are usually conducted remotely or in person over two to three hours. The panel will have read the papers, so the most useful contribution is targeted rather than a full retelling. Expect questions about specific domains and about the day to day picture. Bringing someone with you is sensible, and the person's own voice, where they can take part, carries real weight.
If the panel does not find in your favour
The remaining route is the Parliamentary and Health Service Ombudsman, which considers maladministration rather than reopening the clinical judgement. Judicial review is available in principle where a decision is unlawful, but it is a limited and time-critical remedy addressing legality rather than merits, and it warrants proper legal advice.
Key takeaway
The panel is the first independent stage, considers process and eligibility, and recommends to the Board. Refer within six months of local resolution concluding, prepare a structured written submission organised by domain, and address the four key characteristics directly.
Frequently asked questions
Is the panel's decision binding?
It is a recommendation to the Integrated Care Board rather than a binding order, but recommendations are followed in practice and departing from one would require substantial justification.
Do I have to complete local resolution first?
Normally yes. NHS England will generally expect local resolution to have concluded. If the Board has failed to conclude it despite requests, explain that in the referral.
Can I bring someone with me?
Yes. You can bring a family member, friend, advocate or professional representative. It is sensible to do so, since hearings cover a lot of ground in a few hours.
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.