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NHS Continuing Healthcare
NHS Independent Review Panel: Application and Representation
The Independent Review Panel is the NHS England stage of a Continuing Healthcare appeal, reviewing whether the Integrated Care Board followed proper procedure and applied the National Framework correctly. We handle the application and the panel representation as one merged stage: a registered professional prepares the application, builds the evidence bundle and represents the family at the panel. The fee is £6,250 plus VAT, with travel charged separately.
One merged stage: the IRP application and representation at the panel, prepared and delivered by registered professionals
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
A prepared application and representation at the hearing
Coverage
England. Wales runs its own Continuing NHS Healthcare framework
£6,250
Fixed fee, plus VAT
One working day
Response to your enquiry
England
Cover throughout the country
Social work led
Registered professionals
Plain-English explanation
What the Independent Review Panel is
The application to, and representation at, the final NHS stage of a Continuing Healthcare appeal, convened by NHS England once local resolution is exhausted.
The IRP is the second and final stage of the NHS appeal process, convened by NHS England once local resolution is exhausted. It reviews both the eligibility decision and whether the process was properly followed.
We prepare the application, assemble the bundle and represent the person at the panel, as one merged stage.
The panel looks at the process, not only the scoring
An Independent Review Panel reviews whether the framework was followed as well as whether the domains were scored properly. Procedural failings are grounds in their own right.
Common situations
When your case goes to the panel
The Independent Review Panel is for cases where local resolution with the Integrated Care Board has not resolved the dispute. NHS England convenes the panel, which reviews the procedure the ICB followed and how it applied the National Framework to the evidence.
We handle the application and the panel attendance as a single stage with a single fee, because a strong application and strong representation are the same piece of work: the evidence bundle that persuades on paper is the one we present in the room.
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 application and the bundle prepared properly.
The process was flawed
Procedural failings, as much as scoring, are within the panel’s remit.
You cannot face attending
The hearing is formal, and you would rather it was presented for you.
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 panel reviews two things: whether the eligibility decision was right on the evidence, and whether the process that produced it followed the National Framework. The second is not a technicality, it is half the panel’s remit.
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
You do not have to prove the person was eligible in order to succeed at panel. Showing that the decision was reached in a way the framework does not permit is enough for it to be reconsidered properly.
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
The panel asks two questions: did the ICB follow the proper procedure, and did it apply the National Framework correctly to the evidence? The application and the bundle are built around exactly those questions, judged against the nature, intensity, complexity and unpredictability of the person's needs.
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
Contact us by phone, email or website form. We review where your case stands after local resolution and confirm the route within one working day.
Scope and fee
We confirm the scope, the fee plus VAT and any travel charge, in writing before you commit to anything.
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 evidence bundle is organised domain by domain, so the panel can find every point in the records rather than take anyone's word for it.
The panel and after
Your practitioner represents the family at the panel, presents the case, and afterwards explains the panel's findings and what follows, including the Ombudsman route where needed.
What happens next
Our support process
Evidence base
What we look at
The panel reads a bundle. We make sure it reads the right one.
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
A professional account of the person’s needs.
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 the panel by a registered professional
A written summary of the panel's findings and the next steps
Who we work with
For solicitors, deputies, care providers and advisers
Instruction is straightforward and the evidential standard is consistent whichever stage we are brought in at:
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.
Peer review as standard
A second qualified professional reviews the work before it is submitted.
Honest merits advice
Where a case has no realistic prospect, we say so before you spend anything further on it.
Already working with us
£6,250 plus VAT
- The application to NHS England prepared
- The bundle assembled, indexed and cross-referenced
- Representation at the panel hearing
- Peer review by a second qualified professional
One fee, agreed in writing before any work starts, and never a percentage of what is recovered. Most CHC support is charged by the hour or as a share of the outcome, so the cost is unknown when you commit and grows the longer the case runs. Ours is stated up front, plus VAT and travel, and does not change if the case turns out to be harder than expected.
New to Nellie Supports
£9,300 plus VAT
- The Independent Social Care Needs Assessment and Care Plan, £1,100 plus VAT
- The Case Review and Merits Assessment, £1,950 plus VAT
- Both charged once and never re-charged
- Everything listed in the returning price
Two things sit behind this price. The needs assessment is an independent professional record of what the person actually needs, in the language the twelve care domains are scored in, and every later stage builds on it. The merits assessment is the honest opinion on whether the appeal is worth bringing at all. We would rather tell you a case is weak before you spend on it than take the instruction and bill you for a submission that was never going to succeed.
Transparent pricing
Two prices, depending on whether we already have your case
The work is identical. What differs is whether the gateway assessment has already been done and paid for. It is charged once per client and never re-charged, so every later stage of your case is at the returning price.
For families
A clear fee, agreed in writing before we start, with no percentage of anything recovered. We explain what is happening in plain English and deal with the process so you do not have to.
For professionals
Scope, fee and timescale confirmed in writing before instruction. Evidence prepared against the twelve care domains and the four key characteristics, peer reviewed by a second qualified professional.
Provider evidence
Why choose Nellie Supports for the Independent Review Panel
The panel is the last stage inside the NHS process. It deserves a properly evidenced case.
Why families and professionals choose Nellie Supports
Social work led, not a claims company
Registered professionals prepare and present the evidence of need. We are not a call centre and not a no-win-no-fee operation.
One team, application to panel
The bundle that persuades on paper is the one we present in the room, prepared once and prepared properly.
Published 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.
By the time a daughter contacted us, her mother's case had already been through local resolution and the refusal had been upheld. The family were exhausted and close to giving up, convinced that the same arguments would simply be rejected a third time.
A registered professional prepared the application to NHS England around the two questions the panel actually asks: whether the Integrated Care Board followed proper procedure, and whether it applied the National Framework correctly to the evidence. The bundle was organised domain by domain, so every point the family made could be found in the records rather than taken on trust. At the panel, the same social worker presented the case and answered the panel's questions.
The recommendation was the panel's to make, and the decision that followed was the ICB's. What the family controlled was the quality of the evidence in front of both, and that is what the merged application and representation stage exists to deliver.
The panel had two professional accounts in front of it: the Integrated Care Board’s, and ours. That is not the usual position. Most families reach a panel able only to dispute the evidence the assessing clinicians produced, because they have none of their own. Being a health and social care practice that carries out its own assessments is what put a second, independently authored record on the table.
This is an illustrative example. It does not describe any individual client.
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 independent panel convened by NHS England, separate from the Integrated Care Board that made the decision. It reviews two things: whether the ICB followed the proper procedure, and whether it applied the National Framework correctly to the evidence of the person's needs.
Why are the application and the attendance one fee?
Because they are the same piece of work. The application that persuades NHS England to convene a panel is built from the same evidence bundle we present on the day, so splitting them into separately charged stages duplicates effort and cost. One stage, one fee: £6,250 plus VAT.
Do we need to have been through local resolution first?
Normally yes. The panel expects local resolution with the Integrated Care Board to have been attempted first. If you are earlier in the journey, our appeal support service covers the drafting, submission and representation at that stage, and everything prepared there carries forward to the panel if it is needed. You can also instruct us for the panel alone, having run local resolution yourself.
What happens after the panel?
The panel makes a recommendation to the Integrated Care Board, and in most cases the ICB accepts it. If the outcome still does not resolve matters, or the process itself was mishandled, the remaining route is a referral to the Parliamentary and Health Service Ombudsman, which we support as a separate service.
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.
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.
Support with a referral to the Parliamentary and Health Service Ombudsman about how the process 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.
Written by Ben Slater, Founder and Managing Director, Nellie Supports. Read our editorial policy.