NHS Continuing Healthcare
CHC Appeal Application: We Draft and Submit Your Challenge
Structured drafting and submission of your CHC eligibility challenge, within the six month window, across England
The CHC appeal application is the formal written challenge to an NHS Continuing Healthcare eligibility decision, submitted to the Integrated Care Board within the six month window. A registered social worker analyses the care records and the Decision Support Tool, sets out where the assessment went wrong, and drafts and submits a structured appeal that opens the local resolution process. The fixed fee is £2,250 plus VAT.
£2,250
Fixed fee, plus VAT, stated before instruction
One working day
Enquiry triage response
England
Wales runs a separate Continuing NHS Healthcare framework
Social work led
Registered social workers, peer reviewed
Nellie Supports is England and Wales' largest identified specialist private social work and mental capacity assessment practice, operating through a permanent, full-time employed team that has completed more than 11,000 assessments. Our NHS Continuing Healthcare support is social work led: we prepare and present the evidence of need. We are not a law firm and not a claims company.
When you need an appeal application
You have received a decision that the person is not eligible for NHS Continuing Healthcare, and the evidence says otherwise. The challenge must be lodged with the Integrated Care Board within six months of the decision, and the quality of the written application shapes everything that follows at local resolution and beyond.
Structure wins CHC appeals, not volume. The application maps the care records to the twelve care domains, critiques the Decision Support Tool scoring where it departed from the evidence, and sets out the case in the language the National Framework requires.
The framework the appeal applies
NHS Continuing Healthcare decisions in England can be challenged through the Integrated Care Board's local resolution process, and there is a six month window to do so. The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, in its 2022 revision, governs how the decision should have been made.
An appeal succeeds on evidence, not volume. The application must show where the Decision Support Tool scoring or the eligibility judgement departed from the evidence of the person's needs, judged by their nature, intensity, complexity and unpredictability.
Nature of the person's needs
Intensity of the person's needs
Complexity of the person's needs
Unpredictability of the person's needs
Framework: National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (2022 revision); the primary health need test; the six month challenge window; ICB local resolution procedures
For more, read our guide: Challenging a CHC decision
Acting as a professional deputy or attorney? Read: Re ACC and CHC appeals: what the ruling means for professional deputies
Our support process
Initial enquiry and triage
Contact us by phone, email or website form. We confirm where your case stands against the six month window within one working day. New clients start with the Case Review and Merits Assessment.
Scope and fixed fee
We confirm the scope, the fixed fee plus VAT and any travel charge, in writing before you commit to anything.
Records and DST analysis
A registered social worker analyses the care records and the completed Decision Support Tool, identifying where the scoring and the eligibility judgement departed from the evidence.
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 lodge the appeal with the Integrated Care Board within the window and explain what happens next at local resolution, with a written summary of the submission.
What you receive
Support is practical and evidence led. You receive:
Full care records analysis
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A critique of the Decision Support Tool scoring
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A structured written appeal, drafted and submitted to the ICB
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A written summary of the submission and the next steps
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Fees
£2,250 plus VAT
Appeal application drafting and submission £2,250 plus VAT, fixed. New clients with no previous Nellie Supports involvement start with a Case Review and Merits Assessment, £1,950 plus VAT, so we only take forward appeals with real merit. Travel is confirmed in writing before booking.
Travel for in-person attendance is confirmed in writing before booking.
Fixed fee confirmed in writing
The whole price, plus VAT, is agreed before instruction.
Records review
A registered social worker reads the care records properly.
Structured drafting
Drafted in the language the National Framework requires.
Submission handled
Lodged with the ICB inside the six month window.
How the appeal application works in practice
A wife received the letter saying her husband was not eligible for NHS Continuing Healthcare four months after his Decision Support Tool meeting. She was sure the assessment had missed things, but the six month window was closing and she did not know how to turn that certainty into a challenge.
A registered social worker analysed the completed DST against the daily care records. Two domains stood out: behaviour had been scored as if his aggression during personal care happened occasionally, when the records showed it daily, and the medication domain ignored the crushed tablets and refusals the carers logged every week. The appeal was drafted as a structured challenge, mapping each disputed score to the written evidence, and lodged with the Integrated Care Board inside the window.
The eligibility decision remained the ICB's to make at local resolution. What changed was that it now had to be made against an organised, evidenced account of the records, not a family's understandable frustration.
This is an illustrative example. It does not describe any individual client.
Why families and professionals choose Nellie Supports
Social work led, not a claims company
Registered social workers prepare and present the evidence of need. We are not a call centre and not a no-win-no-fee operation.
Structure wins, not volume
Volume does not win CHC appeals. Structure does: an organised, evidenced challenge in the framework's own language.
Fixed fees, plus VAT
The whole price is published and confirmed in writing before instruction. No percentages, no surprises.
Peer reviewed as standard
Everything we prepare is reviewed by a second qualified professional before it is used.
Frequently Asked Questions About the CHC Appeal Application
How long do we have to appeal?
Six months from the eligibility decision. Integrated Care Boards can consider late challenges in some circumstances, but nothing is guaranteed once the window closes, so the safest course is to start well before the deadline. If you are close to the six month mark, tell us at first contact and we will prioritise the timetable.
What happens after the appeal is submitted?
The appeal opens the Integrated Care Board's local resolution process. The ICB reviews the decision, and there may be a local resolution meeting, which we can attend under our local resolution service. If local resolution does not resolve the matter, the case can go to the NHS England Independent Review Panel.
Why do new clients need a Case Review and Merits Assessment first?
Because it protects you from paying for an appeal that cannot succeed. For new clients with no previous Nellie Supports involvement, the Case Review and Merits Assessment (£1,950 plus VAT) examines the records and gives an honest opinion on the merits before any appeal work is instructed. Existing clients skip this step because we already know the case.
What does the fixed fee include?
The fixed fee of £2,250 plus VAT covers the records and DST analysis, the drafting of the structured written appeal, agreement of the draft with you, and submission to the Integrated Care Board, with peer review throughout. Attendance at later meetings and panels is quoted separately as its own stage.
Is this legal advice?
No. Nellie Supports provides independent social work assessment, evidence and advocacy support. We do not provide regulated legal advice, and where a legal remedy is needed we will say so and support your solicitor's work.
Related NHS Continuing Healthcare guides
Challenging a CHC decision
The NHS Continuing Healthcare process explained
CHC eligibility and primary health need
Re ACC and CHC appeals: guidance for professional deputies
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
CHC Appeal Support
CHC Mediation
Nellie Supports provides independent social work assessment, evidence and advocacy support. We do not provide regulated legal advice, and where a legal remedy is needed we will say so and support your solicitor's work.
Facing the six month deadline?
Contact Nellie Supports to discuss your CHC appeal application. We will confirm the merits position, the fixed fee and the next steps in writing.
We aim to respond to all enquiries the same working day.
Written by Ben Slater, Founder and Managing Director, Nellie Supports. Read our editorial policy.