NHS Continuing Healthcare
The Independent Review Panel Explained
What the Independent Review Panel is, when to ask for one, what it looks at and what happens after it decides.
What is the Independent Review Panel?
The Independent Review Panel, or IRP, is convened by NHS England to review a disputed NHS Continuing Healthcare decision once local resolution has been exhausted. It has an independent chair and members who were not involved in the original decision. The panel considers the case afresh and makes a recommendation to the Integrated Care Board, which is expected to follow it. Requesting a panel is free.
Plain English
For families and professionals
England and Wales
National coverage
Registered professionals
Written and reviewed
The Independent Review Panel is the formal appeal stage in NHS Continuing Healthcare. It comes after local resolution, when you and the Integrated Care Board have not been able to agree, and it is the last stage before the Ombudsman. The panel is not a court, but it is the point at which an independent group looks properly at both how your case was handled and whether the eligibility decision was right.
When a review is worth requesting
A panel is most likely to help where:
- Local resolution has finished and you still disagree with the decision
- A care domain was scored below what the records support
- Well-managed needs were treated as minor because care kept them stable
- The four key characteristics were not properly weighed together
- The process itself was flawed, for example evidence ignored or the family shut out
How to prepare
The panel decides on the strength of the written case, so preparation matters:
- Set out clearly which domains you dispute and why, tied to the records
- Gather the evidence that was overlooked or under-weighted first time
- Explain the person's needs against nature, intensity, complexity and unpredictability
- Keep the argument focused on the strongest points rather than every disagreement
- Bring a paginated, indexed bundle so the panel can find the evidence
Where people often go wrong
- Appealing everything rather than the domains where the records are strongest
- Missing the six-month window to request a review
- Arguing about the diagnosis rather than the level and quality of need
- Turning up without the evidence organised for the panel to follow
- Treating the panel as a formality rather than preparing a proper case
- Appealing everything rather than the domains where the records are strongest
- Missing the six-month window to request a review
- Arguing about the diagnosis rather than the level and quality of need
- Turning up without the evidence organised for the panel to follow
- Treating the panel as a formality rather than preparing a proper case
What the panel reviews
A panel looks at two things. First, whether the correct process was followed, including whether the right evidence was gathered and whether the person and their family were properly involved. Second, whether the recommendation on the primary health need was reasonable on the evidence. It is not simply a re-run of the Decision Support Tool; it tests whether the decision holds up, and it can find that a domain was scored wrongly or that the four key characteristics were not properly weighed.
Frequently Asked Questions
Who sits on an Independent Review Panel?
An independent chair and panel members who had no part in the original decision, supported by clinical and social care advice. The Integrated Care Board is represented, and you and your representative can attend and speak.
Is the panel's decision binding?
The panel makes a recommendation to the Integrated Care Board. In practice the Board is expected to accept it, and should give clear reasons if it does not.
How long do I have to request a panel?
Normally six months from the date you were told the eligibility decision. It is worth asking in writing as soon as local resolution has finished.
What if the panel does not find in my favour?
The final stage is the Parliamentary and Health Service Ombudsman, which considers whether the process amounted to maladministration that caused injustice.
This page explains the NHS Continuing Healthcare Independent Review Panel in England. It is general information rather than legal advice, and it does not replace an assessment of an individual's needs.