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 explains how to prepare for an NHS Continuing Healthcare local resolution meeting. It covers obtaining the paperwork, structuring a written submission by domain, deciding which points to lead with, what to ask before the meeting, who to bring, how to conduct yourself on the day and what to do afterwards.
Preparing for a CHC Local Resolution Meeting
Local resolution is decided far more by what you send in advance than by what you say in the room. A structured written submission, sent a fortnight before, does most of the work.
Get the paperwork first
You need the completed Decision Support Tool, the multidisciplinary team recommendation and the written decision with reasons. Without all three you cannot see whether the Board identified a defect in the assessment or simply reached a different view. Request them in writing and ask for the meeting to be deferred if they arrive too late to prepare properly.
Read the three documents together
Work through the tool domain by domain, checking whether each level matches the narrative recorded beneath it. Then read the recommendation, and then the decision. The most productive findings are internal inconsistencies, most often a narrative describing significant skilled intervention sitting above a moderate level.
Structure the submission by domain
For each domain you are challenging, state the level recorded, the level you say applies, quote the descriptor, and list the evidence with dates. Then add a separate section on the four key characteristics, and a further section on any procedural failures. Three clear headings beat a chronological narrative every time.
Lead with your strongest points
Choose the two or three domains where the gap between the record and the evidence is widest, and put them first. Reviewers work through a great deal of material, and a submission that front-loads its strongest material is more likely to have those points properly addressed.
Send it in advance
Aim for two weeks before the meeting, with the evidence bundle attached and paginated. Ask for confirmation of receipt and ask that it be circulated to everyone attending. Raising a point for the first time in the room gives nobody a chance to consider it, and it is easily deflected as something to look into later.
Ask who is attending
Ask in advance who will attend and in what capacity, particularly whether anyone was involved in the original decision. That tells you how much background to give and whether you are speaking to people who already know the case. You can bring someone with you, and it is usually worth doing.
On the day and afterwards
Take notes, including who said what. Ask for anything agreed to be confirmed in writing. Afterwards, ask for written confirmation of the outcome and, importantly, written confirmation that local resolution has concluded, since the six month period for referring to NHS England runs from that point and Boards often leave it unclear.
Key takeaway
Get all three documents, read them against each other, and send a domain-structured submission two weeks in advance with paginated evidence. Lead with your strongest two or three points, and get written confirmation when the stage concludes.
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Frequently asked questions
What should I send in advance?
A submission structured by care domain, with a separate section on the four key characteristics and another on procedural failures, plus a paginated evidence bundle. Send it around two weeks before and ask for confirmation of receipt.
How long should it be?
Two to four pages with the evidence behind it. A focused submission leading with the strongest two or three domains is more likely to have each point addressed than a long narrative.
Can I bring someone?
Yes, and it is usually worth doing. A family member, friend, advocate or professional representative can attend with you. Tell the Board in advance who is coming and in what capacity.
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.