Nellie Supports · NHS Continuing Healthcare
CHC Appeal Application: Drafting and Submission
Turn supported concerns about a CHC decision into a clear written challenge. Using the completed merits review, we organise the evidence, draft the appeal and submit it to the ICB within the agreed timetable. Drafting is a separate instruction from case review and meeting representation. We confirm the scope and total fee in writing before work begins. Travel is charged separately.
Turn supported concerns about a CHC decision into a clear written challenge. Using the completed merits review, we organise the evidence, draft the appeal and submit it to the ICB within the agreed timetable. Drafting is a separate instruction from case review and meeting representation. We confirm the scope and total fee in writing before work begins. Travel is charged separately.
All travel is charged separately at £48 per hour including VAT (£40 excluding VAT). The travel cost and any additional work are confirmed in your written quotation before booking.
Evidence-based appeal drafting and submission for CHC decisions in England.
At a glance
Role
Drafting and submitting the written challenge to a CHC decision
Framework
National Framework for NHS CHC and NHS-funded Nursing Care, 2022 revision
Format
Drafting and evidence assembly following the merits review.
Deliverable
An agreed written challenge, supporting evidence and a record of submission.
Coverage
England only. Wales has a separate Continuing NHS Healthcare framework.
Who this service supports
Who are you arranging this for?
We agree how the person will be involved, who can instruct us and who should receive updates.
I am supporting a family member
You have someone to explain the process, organise the relevant evidence and help you put the person's needs into words. The work and fee are agreed before we start.
I am instructing as a professional
We agree the instruction, authority to act, evidence required, reporting arrangements and timetable with you. Written work links each point to its source.
Understanding this service
Nellie Supports is an independent social work practice. Our NHS Continuing Healthcare support helps families and professionals in England explain care needs and present relevant evidence.
What an appeal application is
A written challenge setting out the disputed findings, the relevant evidence and the review requested.
The appeal explains which findings are disputed, why the records support a different view and any material failure to follow the National Framework.
We draft from the completed merits work, agree the submission with you and confirm the timetable against the decision letter.
When you need an appeal application
This service fits where the merits have been reviewed and a written challenge is justified. If Nellie is new to the case, the independent assessment and merits review come first.
Each point is linked to the relevant record and the needs at the time of the disputed assessment. Later deterioration is kept separate from the grounds of appeal.
A not eligible letter has arrived
You want the decision reconsidered and the deadline is running.
Domain scores look wrong
The levels recorded do not match the care records.
The process was not followed
Notice, attendance or evidence gathering fell short of the framework.
Relevant participation or professional input was missing
You want the appeal to explain the omission and why it matters to the decision.
Relevant historical evidence has been found
Records relating to the original assessment period were not previously considered.
You are advising a client
A professional needs the challenge drafted to a standard that will be scrutinised.
Choice and decision-making
A refusal is not the end of the process
A refusal can be reviewed, but disagreement alone does not establish that the decision was wrong. We focus the submission on supported points and the applicable deadline.
The framework the appeal applies
The ICB's local resolution process is normally the first review stage. Check the decision letter promptly for the deadline and how to request a review.
The appeal connects the disputed findings with contemporaneous evidence and the overall primary health need reasoning, rather than relying on a higher score alone.
National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care; the primary health need test; ICB local resolution arrangements and the relevant deadline.
Read the supporting guidance
Nature of the person's needs
Intensity of the person's needs
Complexity of the person's needs
Unpredictability of the person's needs
Our support process
Initial enquiry and triage
Tell us the decision and DST dates and any deadline. New appeal clients need an independent assessment and merits review before drafting is commissioned.
Scope and fee
We confirm the scope, total fee including VAT, payment stages and any additional costs in writing before you instruct us. Further work is agreed before it starts.
Use the completed merits analysis
We use the reviewed evidence and agreed grounds. Any further analysis or records work is identified in the scope, so the same merits work is not charged twice.
Drafting the appeal
The appeal is drafted as a structured written challenge, mapped to the twelve care domains and the National Framework, and agreed with you before anything is sent.
Submission and what follows
We submit as agreed, retain a record of what was sent and explain the next local resolution step. A later meeting requires a separate instruction unless expressly included.
Evidence we consider
What we look at
The appeal is built line by line from what the papers actually show.
The decision letter
What was decided, on what basis, and by when it can be challenged.
The Decision Support Tool
Every domain level and the reasoning behind it.
The care records
The evidence the scoring should have reflected.
Clinical correspondence
GP, nursing, therapy and specialist input across the period.
The Checklist
How the person entered the process.
Framework compliance
Whether the process met the framework’s own requirements.
What you receive
Support is practical and evidence led. You receive:
Evidence assembled from the completed review
Supported grounds linked to the DST, decision and relevant records
A structured written appeal, drafted and submitted to the ICB
A written summary of the submission and the next steps
Fees
Fee confirmed in writing
We quote for appeal drafting and submission after confirming the grounds and evidence work already completed. New appeal cases require a separate independent assessment and merits review. Meeting attendance is excluded unless expressly included in your scope.
Fee confirmed in writing
The total fee including VAT, scope and any additional attendance costs are agreed before instruction.
Reviewed evidence carried forward
The completed merits analysis provides the basis for drafting, with any additional work agreed first.
Structured drafting
Drafted in the language the National Framework requires.
Submission handled
Submitted within the timetable agreed against the relevant decision letter.
How the appeal application works in practice
A family has completed a merits review and wants help turning the supported points into a written challenge.
In this example, we would organise the assessment-period evidence, explain each disputed finding and agree the draft before submitting it to the ICB.
The family would have a clear written case and record of submission. The ICB would remain responsible for the review decision.
Illustrative example only. This does not describe a client or predict an NHS or Ombudsman decision.
For professionals
For solicitors, deputies, care providers and advisers
We agree a clear instruction and reporting arrangements before starting work.
Scope confirmed in writing
The stage, the fee and the timescale are confirmed in writing before instruction.
Evidence in the language of the framework
Needs are described against the twelve care domains and the four key characteristics, not in general terms.
Evidence and reasons explained
The written work identifies the records used, the reasons for our view and any gaps that could affect it.
A reasoned next step
We explain where the evidence does not support further work and what other route may be relevant.
Why choose Nellie Supports
Why choose Nellie Supports to draft your appeal
A focused submission makes the supported concerns and requested review easier for the ICB to follow.
For families
You have someone to explain the process, organise the relevant evidence and help you put the person's needs into words. The work and fee are agreed before we start.
For professionals
We agree the instruction, authority to act, evidence required, reporting arrangements and timetable with you. Written work links each point to its source.
Why families and professionals choose Nellie Supports
Independent social work support
Our social work approach connects the person's everyday needs with the evidence and questions relevant to the CHC stage.
Focused grounds and traceable evidence
Each point explains what is disputed, the record supporting it and why it matters under the Framework.
Fees including VAT
Your scope and total fee including VAT are confirmed before instruction. Additional work is agreed before it starts.
Written work you can follow
The written work identifies the records used, the reasons for our view and any gaps that could affect it.
Frequently Asked Questions About the CHC Appeal Application
How long do we have to appeal?
Check the decision letter and request review promptly. Six months is normally expected, but the relevant procedure and any correspondence must be checked. Late requests may be refused. Tell us immediately about a close or missed deadline.
What happens after the appeal is submitted?
The ICB considers the request through local resolution. A meeting may follow. Representation at that meeting is separate unless included in your instruction; independent review by NHS England may be relevant if the dispute remains unresolved.
Why do new clients need a Case Review and Merits Assessment first?
We review the evidence before recommending or drafting an appeal. The independent assessment and merits review are separate from this drafting service. Existing continuing cases do not routinely repeat work already completed.
What does the fee include?
Your quote identifies the drafting, evidence assembly, agreement of the submission and submission work included. Further records analysis, meetings and later review stages are separately agreed.
Is this legal advice?
No. Nellie Supports provides independent social work assessment, evidence and advocacy support in England. We do not provide regulated legal advice. We explain when a solicitor's advice is needed.
Related NHS Continuing Healthcare guides
Challenging a CHC decision
The stages of challenge and what makes an appeal persuasive.
The NHS Continuing Healthcare process explained
A plain English guide to the Checklist, the Decision Support Tool, the MDT and the ICB decision.
CHC eligibility and primary health need
What a primary health need is and how the four key characteristics are judged.
Re ACC and CHC appeals: guidance for professional deputies
What the Re ACC ruling means for professional deputies challenging NHS Continuing Healthcare funding decisions.
Other CHC support stages
If your situation is at a different stage, our team supports the full NHS Continuing Healthcare pathway.
Independent Social Care Needs Assessment & Care Plan
The independent assessment underpinning Nellie's casework, included where specified in the new client package.
CHC Appeal Support: Local Resolution
Written submission and representation at local resolution with the Integrated Care Board, the first stage of a CHC appeal. The Independent Review Panel is a separate service.
CHC Mediation
Representation at ICB mediation, where the ICB offers it.
Nellie Supports provides independent social work assessment, evidence and advocacy support in England. We do not provide regulated legal advice. We explain when a solicitor's advice is needed.
Tell us the decision date, deadline and any merits work already completed. We will confirm whether drafting is the right service and provide the scope and fee in writing.
Tell us about any urgent date at first contact so we can confirm whether the required timetable can be met.