NHS Continuing Healthcare Support
Make your next CHC step clearer. Nellie Supports helps families and professionals in England prepare for assessments, present evidence and challenge decisions. You receive independent s…
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Challenging a CHC Decision
For a full CHC eligibility decision in England, request local resolution from the ICB, normally within six months of the written decision. If unresolved, normally request NHS England independent review within six months of the local-resolution outcome. A negative Checklist, care-package dispute or complaint has a different route. Keep each letter and follow its instructions.
NHS Continuing Healthcare
Local resolution, the Independent Review Panel and the Ombudsman, and what actually makes a challenge succeed.
How do I appeal a CHC decision?
For a full CHC eligibility decision in England, request local resolution from the ICB, normally within six months of the written decision. If unresolved, normally request NHS England independent review within six months of the local-resolution outcome. A negative Checklist, care-package dispute or complaint has a different route. Keep each letter and follow its instructions.
Plain English
For families and professionals
England
England framework
Registered professionals
Written and reviewed
A review request should identify the findings or reasoning you dispute, the supporting evidence and any material process concerns. The reviewer can then consider whether the Framework was applied properly and whether the evidence supports the eligibility conclusion. Clear presentation helps explain the concern but does not guarantee a different outcome.
The stages of challenge
Local resolution normally comes before NHS England independent eligibility review. Complaints and judicial review have different remits and deadlines; they are not compulsory final steps in one sequence. Seek legal advice early if a court challenge may be needed.
- Local resolution: a request to the Integrated Care Board to review its own decision
- Independent Review Panel: convened by NHS England where local resolution fails
- Public Service Ombudsman: considers unresolved NHS complaints within its remit; formerly the Parliamentary and Health Service Ombudsman
- Judicial review: rare, and a matter for solicitors rather than assessors
- Fresh assessment: appropriate where needs have changed since the original decision
How to prepare
Request the decision papers and relevant records, but register your review request within the deadline even if some paperwork is outstanding. Ask when detailed grounds or further evidence must follow.
- Request the full assessment file, including the completed Decision Support Tool
- Note the date of the written decision, which starts the time limit running
- Identify the specific domains you say are wrong, and why
- Assemble the evidence that contradicts each disputed level
- Record any procedural failure separately from the disagreement on need
Where people often go wrong
- Appealing in general terms rather than domain by domain
- Missing the six month window for requesting local resolution
- Arguing about the diagnosis instead of the level of need
- Not requesting the assessment file before writing the challenge
- Going straight to the Ombudsman before the earlier stages are exhausted
- Appealing in general terms rather than domain by domain
- Missing the six month window for requesting local resolution
- Arguing about the diagnosis instead of the level of need
- Not requesting the assessment file before writing the challenge
- Going straight to the Ombudsman before the earlier stages are exhausted
What makes a challenge succeed
Strong challenges are specific. They identify the domain levels that are wrong, set out the evidence that contradicts them, and show why the recorded reasoning on primary health need does not follow from the scores. They also identify process failures: evidence not gathered, the family excluded, disagreement not minuted, or reasoning simply absent from the written decision.
Preparing a review request
Check the decision type and deadline, then request the DST, recommendation and reasons. Set out the disputed evidence, descriptors and characteristics with dated references. Ask about free advice or advocacy if useful.
Related pages
NHS Continuing Healthcare ExplainedCHC Eligibility and Primary Health NeedThe CHC Assessment ProcessNHS Continuing Healthcare services
Frequently Asked Questions
How long do I have to appeal a CHC decision?
You normally have six months from the date of the written eligibility decision to ask the Integrated Care Board for local resolution. The time limit runs from the decision letter rather than from the assessment meeting, so keep the letter and note the date it is received.
What is an Independent Review Panel?
NHS England convenes an independent review panel where appropriate after local resolution. It normally has an independent chair, an ICB representative and a local authority representative independent of the original decision; clinical advice may be sought. It reviews the process and eligibility reasoning, then makes a recommendation. NHS England communicates the outcome to you and the ICB.
Can I challenge a decision to withdraw CHC funding?
Yes. A full reassessment should precede a new ineligibility decision where a clear change in needs may affect eligibility. Ask for written reasons, notice and safe care arrangements. A personal appeal does not automatically preserve CHC funding throughout; local resolution and NHS England review have separate deadlines.
Do I need a solicitor to appeal?
No paid representative or solicitor is required for NHS local resolution or independent review. The help you need depends on the concern, records, time and expertise involved. Free information or advocacy may assist. Obtain prompt legal advice if court proceedings may be needed.
This page explains how NHS Continuing Healthcare decisions are challenged in England. It is general information rather than legal advice. Nellie Supports is an independent social work practice and does not provide regulated legal services. Primary guidance: NHS England, Independent review process public information guide. https://www.england.nhs.uk/wp-content/uploads/2020/03/nhs-continuing-healthcare-independent-review-process.pdf
Keeping the next stage clear
Keep the local-resolution letter, note the separate NHS England request and application deadlines, and ask for adjustments or help if the process is difficult to use. Do not assume NHS review extends any court deadline.