Nellie Supports · NHS Continuing Healthcare
NHS Independent Review Panel: Application and Representation
When local resolution has not resolved a CHC dispute, we can help request independent review by NHS England and represent the case if a panel is convened. We prepare the application and relevant evidence, then explain the outcome and next steps. £11,160 including VAT for new clients; £7,500 including VAT for eligible existing cases. Travel is charged separately.
Service overview
NHS Continuing Healthcare
When local resolution has not resolved a CHC dispute, we can help request independent review by NHS England and represent the case if a panel is convened. We prepare the application and relevant evidence, then explain the outcome and next steps. £11,160 including VAT for new clients; £7,500 including VAT for eligible existing cases. 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.
An agreed instruction covering the NHS England application, evidence preparation and representation if a panel is convened.
At a glance
Role
Application to, and representation at, the NHS Independent Review Panel
Framework
National Framework for NHS CHC and NHS-funded Nursing Care, 2022 revision
Format
Written application and attendance at the panel
Deliverable
An application, organised supporting evidence and representation at a convened panel.
Coverage
England only. Wales has a separate Continuing NHS Healthcare framework.
New clients: £11,160 including VAT
Eligible existing cases: £7,500 including VAT
Tell us any deadline
Meeting or decision date
England
Cover throughout the country
Social work led
Registered professionals
What it is
When it is needed
Relevant information
Legal test
Process
The report
Fees
Case study
FAQs
Plain-English explanation
What the Independent Review Panel is
Application and representation support for NHS England's independent review process following local resolution.
Independent review examines the ICB's assessment procedure and how it applied the National Framework. NHS England considers the application before deciding whether a panel should be convened.
We prepare the application and evidence, support the agreed panel stage and explain the outcome. Your instruction confirms the work included if a panel is not convened.
The panel looks at the process, not only the scoring
The review can consider material procedural concerns as well as how needs and eligibility were assessed. An identified defect does not itself guarantee funding or a new assessment.
Common situations
When your case goes to the panel
This service normally follows the ICB's local resolution outcome. Send us that letter, the review history and any deadline promptly.
Application and representation are one instruction because the evidence prepared for review is also the basis for presenting the case. The written scope explains each stage and any exclusions.
Local resolution has been exhausted
The ICB has upheld its decision and the next stage is the panel.
A panel date has been set
You need the case and evidence ready for the timetable set by NHS England.
The process was flawed
Procedural failings, as much as scoring, are within the panel’s remit.
You cannot face attending
You want support explaining the case and responding to the panel's questions.
The case is complex
Multiple periods, settings or domains are in issue.
A professional is instructing
A deputy, attorney or solicitor needs panel representation.
What the panel examines
What the Independent Review Panel looks at
The review considers the procedure followed and whether the National Framework was applied correctly to the person's needs at the time of the disputed assessment.
Whether the Checklist and the full assessment were carried out as the framework requires
Whether the multidisciplinary team was genuinely multidisciplinary
Whether the evidence that was available was gathered and considered
Whether each domain level is supported by the records
Whether the reasoning behind the decision was recorded in writing
Whether the person and their family were given a proper part in the process
A flawed process is a ground in itself
A material procedural concern may support review, but its significance and the appropriate response depend on the case. Neither a panel nor a funding outcome is automatic.
1
Procedure and the eligibility decision
Where local resolution does not resolve an NHS Continuing Healthcare dispute, the case can go to an Independent Review Panel convened by NHS England. The panel is independent of the Integrated Care Board that made the decision.
Whether the ICB followed the required assessment procedure
Whether it applied the primary health need test correctly
Whether the records support the eligibility decision
The findings and recommendation arising from the review
2
How the evidence supports the review
We build the application around supported procedural concerns and the assessment-period evidence, including the total needs and primary health need reasoning.
Framework: National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (2022 revision); NHS England Independent Review procedures; the primary health need test
For more, read our guide: The Independent Review Panel explained
Also see: Challenging a CHC decision
Acting as a professional deputy or attorney? Read: Re ACC and CHC appeals: what the ruling means for professional deputies
The framework
What an Independent Review Panel examines
Initial enquiry and triage
Send the local resolution outcome, earlier decision and DST, with any deadline or NHS England correspondence. We confirm the route and timetable before booking.
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.
The application
A registered professional prepares the application to NHS England, setting out where the ICB departed from proper procedure or misapplied the National Framework.
The evidence bundle
The relevant evidence is organised and cross-referenced to each supported point, so the panel can find the record behind it.
The panel and after
If a panel is convened, we provide the agreed representation. We then explain the written findings and any remaining route for concerns about the process.
What happens next
Our support process
Evidence base
What we look at
We organise the relevant evidence and identify missing material that may affect the case.
The full decision history
Checklist, DST, decision letter and local resolution outcome.
The care records
The evidence behind every domain in issue.
The independent needs assessment
An account of needs during the assessment period, based on relevant historical evidence.
Clinical evidence
GP, nursing, therapy and specialist input across the period.
Process compliance
Notice, attendance, evidence gathering and timescales.
The submission bundle
Indexed, paginated and cross-referenced to the argument.
Deliverable
What you receive
Support is practical and evidence led. You receive:
The IRP application, prepared and submitted to NHS England
An organised, domain-mapped evidence bundle
Representation at a convened panel within the agreed scope
A written summary of the panel's findings and the next steps
Who we work with
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 submission identifies the records, reasoning and any limitations on the position advanced.
A reasoned next step
We explain the grounds, weaknesses and gaps before further work is agreed.
Already working with us
£7,500 including VAT
- The application to NHS England prepared
- The bundle assembled, indexed and cross-referenced
- Representation at the panel hearing
- Written reasoning and evidence sources explained
The existing case fee applies where the relevant assessment and merits work is already suitable. Your written scope confirms the application, panel representation and any additional costs, including what happens if no panel is convened.
New to Nellie Supports
£11,160 including VAT
- Independent needs assessment and care plan for the relevant period
- Case Review and Merits Assessment
- Relevant work carried forward, with updates for the same continuing case included
- The application, evidence preparation and agreed panel representation
The new client package includes the assessment and merits work needed to understand the case before presenting it. We identify supported grounds, weaknesses and gaps rather than promising that NHS England will convene a panel or change the decision.
Transparent pricing
Two prices, depending on whether we already have your case
£11,160 including VAT for new clients; £7,500 including VAT for eligible existing cases. We confirm which earlier work remains suitable and the full scope before instruction.
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.
Provider evidence
Why choose Nellie Supports for the Independent Review Panel
A clear application and organised evidence help NHS England understand the disputed points and their basis.
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.
One team, application to panel
The application and representation use the same organised evidence, with the scope and arrangements confirmed at the start.
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.
A family remains concerned about a refusal after local resolution and wants help requesting independent review.
In this example, we would prepare the supported points, organise the evidence for the disputed period and represent the case if NHS England convened a panel.
The review recommendation and the ICB's response would remain matters for the NHS. We would explain the written outcome and next step.
The family would have an organised case with the source of each significant point identified, rather than needing to manage the application and presentation alone.
Illustrative example only. This does not describe a client or predict an NHS or Ombudsman decision.
How the Independent Review Panel works in practice
Frequently asked questions
Frequently Asked Questions About the Independent Review Panel
What is the Independent Review Panel?
An NHS England review of the ICB's procedure and application of the National Framework. NHS England considers the application and may convene an independent panel; a panel is not automatic.
Why are the application and the attendance one fee?
Both stages use the same prepared case. The fee is £11,160 including VAT for new clients or £7,500 including VAT for eligible existing cases. Your scope explains the application work, representation and arrangements if no panel is convened.
Do we need to have been through local resolution first?
Normally the ICB's local resolution process should be completed first. We check the outcome letter and any exceptional circumstances. NHS England also sets requirements for returning its application form, so send that correspondence promptly.
What happens after the panel?
NHS England communicates the review outcome and recommendation. We explain what it means and whether concerns about an unreasonable or unfair process may fall within the Public Service Ombudsman's remit. Further support is 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.
The stages of challenge and what makes an appeal persuasive.
A plain English guide to the Checklist, the Decision Support Tool, the MDT and the ICB decision.
What a primary health need is and how the four key characteristics are judged.
What the Re ACC ruling means for professional deputies challenging NHS Continuing Healthcare funding decisions.
Supporting guidance
Related NHS Continuing Healthcare guides
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.
A focused, evidenced complaint to the Public Service Ombudsman about how the CHC case was handled.
Other CHC support stages
Discuss your case
Local resolution has not resolved it?
Contact Nellie Supports to discuss the Independent Review Panel. We will review where your case stands, confirm the fee and set out the next steps in writing.
Practice leadership: Ben Slater, Founder and Managing Director, Nellie Supports. Read our editorial policy.