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. Parliamentary and Health Service Ombudsman. Making a complaint about the NHS in England. Available at: https://www.ombudsman.org.uk
3. R (Grogan) v Bexley NHS Care Trust and others [2006] EWHC 44 (Admin).
4. Mental Capacity Act 2005, c. 9. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents
Copywright
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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 describes what happens at an NHS England Independent Review Panel hearing for NHS Continuing Healthcare. It covers the papers circulated beforehand, who attends, the format and typical length, how questioning works, the role of the person and their family, what happens at the end, and how and when the outcome is communicated.
What happens at an Independent Review Panel hearing
The Independent Review Panel hearing is the first time the case is heard by people with no connection to the original decision. Knowing the format removes most of the anxiety, and the panel is generally more approachable than families expect.
Before the hearing
The panel receives a bundle in advance containing the Decision Support Tool, the recommendation, the decision, the local resolution correspondence and any submissions from you. Send anything additional well before the deadline. The panel will have read the papers, so the hearing is about testing and clarifying rather than presenting the case from scratch.
Who attends
Typically 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 Integrated Care Board attends to explain its decision. You attend, and you can bring family, an advocate or a professional representative. The person themselves can attend where they are able to.
Format and length
Hearings run remotely or in person and usually last two to three hours. The chair will explain the process at the start. The Board will be asked to explain its decision, you will be asked to put your case, and the panel will ask questions of both. It is a structured discussion rather than a court hearing, and it is not adversarial in tone.
How questioning works
The panel will ask specific questions, often domain by domain, about the day to day picture. Concrete examples with dates are far more useful than general statements. If you do not know something, say so rather than speculating. If a question relates to a point in your submission, refer them to it by page.
The role of the person and family
Where the person can take part, their own account carries real weight and the panel will usually make space for it. Family members are the ones who know what happens overnight and how often the difficult episodes occur, and those are precisely the questions panels ask. Do not assume the professionals present will cover it.
At the end
The panel does not usually announce a decision on the day. It considers the case and makes a recommendation to the Integrated Care Board. The outcome is normally communicated in writing within a few weeks, and it should include reasons. Ask at the hearing when you can expect it.
Key takeaway
The panel has read the papers, so use the time for concrete detail rather than restating the case. Bring dated examples, let the family speak to the overnight and fluctuating picture, and expect a written outcome some weeks later rather than a decision on the day.
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Frequently asked questions
Is it like a court hearing?
No. It is a structured discussion rather than an adversarial process. The chair explains the format at the start, and panels are generally more approachable than families expect.
How long does it last?
Usually two to three hours, held remotely or in person. The panel will have read the papers in advance, so the time is used for questions and clarification.
Can the person attend?
Yes, where they are able to. Their own account carries real weight and the panel will usually make space for it. You can also bring family, an advocate or a professional representative.
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.