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 sets out the recurring reasons NHS Continuing Healthcare appeals do not succeed. It covers general disagreement in place of specific grounds, absence of contemporaneous evidence, arguing diagnosis rather than need, describing the managed presentation, missing deadlines, running complaints as eligibility grounds, and submissions too long to be engaged with, together with what to do instead.
Common reasons CHC appeals do not succeed
Most unsuccessful appeals fail for reasons that are fixable. They are rarely about the strength of the underlying case and much more often about how the case has been put. This guide sets out the recurring patterns and the alternative in each.
General disagreement instead of specific grounds
The most common weakness is a submission that says the decision was wrong without saying where. Reviewers need something to check. Naming the domain, quoting the descriptor contended for and pointing to dated evidence gives them that. Convert every general statement into a specific, checkable claim before submitting.
No contemporaneous evidence
Recollection, however accurate, is difficult for a reviewer to act on. Care plans, charts, incident logs and daily notes carry weight precisely because they were written at the time for another purpose. Where an appeal relies mainly on what the family remembers, obtaining the records first will usually change the outcome more than anything else.
Arguing the diagnosis
Submissions that emphasise how serious a condition is, without translating it into described needs, tend not to succeed. No condition qualifies automatically. The material that moves a decision describes what the condition means day to day, what intervention it requires, how often, and what happens without it.
Describing the managed presentation
Families sometimes undermine their own case by describing how settled the person is under a good care package. That description gets recorded and supports lower levels. The correct framing states the need as it would be without the intervention, alongside the intervention required to control it.
Missing the deadlines
Six months to request local resolution, six months to refer to NHS England. Late requests can be accepted at discretion, but discretion is uncertain and a missed deadline adds an obstacle that need not exist. Where time is short, a holding letter stating that grounds will follow protects the date.
Running complaints as eligibility grounds
Delay, poor communication and staff conduct are genuine grievances but they do not go to eligibility. Raised within an appeal they dilute the stronger points and invite a response about process rather than about need. Run them separately through the complaints process.
Submissions too long to engage with
A thirty page narrative is less effective than four focused pages with an evidence bundle. Reviewers work through many cases and points that are hard to find are easy to miss. Lead with the two or three strongest domains and put everything else behind them.
Giving up at local resolution
Local resolution is the Board reviewing itself, so an unsuccessful outcome there is not the end and should not be treated as a verdict on the merits. The Independent Review Panel is the first independent stage, and a meaningful proportion of cases turn there. Keep the written record so the panel can see what was argued.
Key takeaway
Be specific, evidence it contemporaneously, describe needs without the care in place, keep to the deadlines, run complaints separately, keep it short, and do not stop at local resolution. Most unsuccessful appeals fail on presentation rather than on merit.
Frequently asked questions
Does a failed local resolution mean the case is weak?
Not at all. Local resolution is the Integrated Care Board reviewing its own decision, so it is not independent. The Independent Review Panel is the first independent stage and a meaningful proportion of cases turn there.
Is a longer submission better?
No. Four focused pages with an evidence bundle outperform a long narrative. Reviewers work through many cases, and points that are hard to find are easy to leave unaddressed.
Should I mention how poorly we were treated?
Raise it, but separately through the complaints process. Within an eligibility appeal it dilutes the stronger points and invites a response about process rather than about need.
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.