NHS Continuing Healthcare
Retrospective CHC Claims Explained
Previously Unassessed Periods of Care: who can claim, the time limits, and how the records decide it.
What is a retrospective CHC claim?
A retrospective NHS Continuing Healthcare claim asks the Integrated Care Board to assess a past period of care that was never assessed for CHC eligibility at the time, often called a Previously Unassessed Period of Care, or PUPoC. If the care records from that period show the person had a primary health need, care fees paid during it can be repaid. The claim is decided on the records from the time, not on how the person is today.
Plain English
For families and professionals
England and Wales
National coverage
Registered professionals
Written and reviewed
Thousands of people paid for their own care during periods when NHS Continuing Healthcare was never considered: no Checklist, no assessment, no eligibility decision. Not because they were found ineligible, but because nobody ever asked the question. A retrospective claim asks it now, for the period when it should have been asked.
When a retrospective claim may apply
A retrospective claim is for periods where the assessment never happened. It is not the route for disagreeing with a decision that was made; that is an appeal.
- The person paid for their own care and no Checklist or assessment was ever completed
- The person has died, and the family has found years of care fees with no record of any CHC assessment
- Care needs rose sharply during a period, a hospital discharge or a move to nursing care, and nobody screened for CHC at the time
- An assessment happened later, but an earlier period of the same care was never looked at
- Not the right route: you disagree with an eligibility decision that was made, which is challenged through the appeal stages instead
How to prepare
A retrospective claim stands or falls on the paperwork from the period, so establish what exists before committing to anything.
- Identify the exact period you believe was never assessed
- Confirm the funding position at the time: who was paying, and how much
- Gather care fee invoices, statements and contracts for the period
- Find out where the care records from the time are held, and request them early
- Where the person has died, locate the grant of probate or letters of administration
How a retrospective claim is decided
The Integrated Care Board reviews the care records from the period, daily notes, medication charts, incident logs and professional correspondence, and considers whether the person's needs at the time amounted to a primary health need, judged by their nature, intensity, complexity and unpredictability. The person's diagnosis matters less than what the records show about their day-to-day needs. This is why the strength of a claim can be assessed in advance: the records either contain the evidence or they do not, and an honest review of a sample tells you which before any claim is made.
A social work led multidisciplinary practice
We start every retrospective case with a qualification review of the records, credited in full against the claim fee if you proceed, so families never pay for a claim the evidence does not support. Where the claim proceeds, we map the historic records to the framework's care domains and submit a structured claim to the Integrated Care Board. Fixed fees only, never a percentage of any repayment.
Frequently Asked Questions
Who can make a retrospective claim?
The person themselves, or someone properly acting for them: a family member with authority, an attorney or deputy, or, where the person has died, the executors or administrators of their estate. Claims on behalf of someone who has died are common, because unassessed periods are often only discovered when families go through the paperwork.
Can we claim for someone who has died?
Yes. The claim is made by the estate, usually through the executors or administrators, and it is decided the same way: on the care records from the period. The person's death does not close the question of whether the NHS should have been funding their care at the time.
What gets repaid if the claim succeeds?
Where the review concludes the person was eligible for a period, the NHS repays the care fees paid during that period, with redress calculated under NHS guidance. Repayment goes to the person, or to their estate where they have died.
How long does a retrospective claim take?
Longer than anyone would like. The Integrated Care Board has to obtain and review historic records, and many boards carry backlogs, so claims are commonly measured in months and sometimes longer. A well organised submission, with the records assembled and the needs mapped to the framework, gives the board less reason for delay.
Do you charge a percentage of the repayment?
No. Nellie Supports charges fixed fees only, published before instruction, and never a percentage of anything recovered. Every retrospective case starts with a qualification review, credited in full against the claim fee if you proceed, so you know whether the records support a claim before committing to one.
This page explains retrospective NHS Continuing Healthcare claims 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.