NHS Continuing Healthcare
CHC Mediation: Representation Where the ICB Offers It
Some Integrated Care Boards offer mediation as a way of resolving an NHS Continuing Healthcare dispute without going further through the appeal process. Where mediation is offered, a registered professional prepares the evidence, represents the family in the mediation itself, and makes sure any resolution is recorded properly. The fee is £1,750 plus VAT, with travel charged separately.
Prepared, represented and properly recorded mediation with the Integrated Care Board, across England
At a glance
Role
Representation at CHC mediation, where the Integrated Care Board offers it
Framework
National Framework for NHS CHC and NHS-funded Nursing Care, 2022 revision
Format
Preparation and attendance at the mediation
Deliverable
Representation, and a clear written position going in
Coverage
England. Wales runs its own Continuing NHS Healthcare framework
£1,750
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 CHC mediation is
Representation at mediation where the Integrated Care Board offers it, with the evidence settled before you walk in.
Some Integrated Care Boards offer mediation as a way of resolving a disputed decision without going to an Independent Review Panel. It is voluntary, and it is not offered everywhere.
Our role is to prepare the position, attend with you and make sure any agreement reached is one the evidence actually supports.
Mediation is voluntary, and not offered everywhere
Some Integrated Care Boards offer it and some do not. It is worth accepting only where the evidence is clear, and it is never a reason to stop preparing for the Independent Review Panel.
Common situations
When mediation may be the right route
Mediation is worth considering when the Integrated Care Board offers it and the dispute turns on how the evidence has been read rather than on missing evidence. It can resolve matters faster and with less strain on the family than pressing on to a panel.
It is not the right route for every case, and it is only available where the ICB offers it. We advise honestly on whether to accept a mediation offer, and if mediation does not resolve the dispute the appeal rights are unaffected.
Mediation has been offered
The ICB has proposed it as a way of resolving the dispute.
Local resolution has stalled
The appeal is going nowhere and an alternative is on the table.
You want to avoid a panel
An IRP is slower and more formal than mediation.
The dispute is narrow
One or two domains are in issue rather than the whole assessment.
You are unsure whether to accept
You want an independent view on whether mediation serves the person.
A professional is instructing
A deputy or solicitor needs the evidence presented at the mediation.
1
The issues mediation can address
Mediation is not a mandatory stage of the NHS Continuing Healthcare process. It sits within the Integrated Care Board's local resolution arrangements, and whether it is offered varies from board to board. Where it is offered, it can resolve a dispute faster than a full appeal journey.
The disputed decision and the issues to discuss
The records and explanations supporting each point
The practical outcomes the parties are seeking
Any agreement, unresolved issues and next steps
2
Evidence, preparation and possible agreement
Mediation only helps if the evidence is ready. We arrive with the records mapped to the twelve care domains and the points of dispute set out clearly, so any agreement reached reflects the person's actual needs rather than negotiating fatigue.
Framework: National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (2022 revision); ICB local resolution procedures; the primary health need test
For more, read our guide: Challenging a CHC decision
The framework
The role of mediation in a CHC dispute
Initial enquiry and triage
Contact us by phone, email or website form. We confirm whether mediation is genuinely on offer and whether it suits your case 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.
Evidence preparation
A registered professional maps the care records to the twelve care domains and sets out the points in dispute, so the mediation starts from evidence rather than impressions.
Representation at the mediation
Your practitioner represents the family in the mediation with the Integrated Care Board, presenting the evidence and keeping the discussion anchored to the National Framework.
Outcome and next steps
Whatever is agreed is recorded properly in writing, and if the dispute is not resolved we explain the appeal routes that remain open, none of which are lost by mediating.
What happens next
Our support process
Evidence base
What we look at
We go into mediation with the same evidence discipline we would take to a panel.
The disputed domains
Exactly what is in issue, and what the records show.
The Decision Support Tool
The scoring and the reasoning recorded against it.
The care records
The day-to-day evidence behind each domain.
The appeal correspondence
What has already been argued and answered.
The ICB’s position
What is actually being offered, and what it means for funding.
What happens if it fails
The route to the Independent Review Panel and the timescales involved.
Deliverable
What you receive
Support is practical and evidence led. You receive:
An evidence summary mapped to the twelve care domains
Representation at the mediation by a registered professional
A properly recorded written outcome
A written explanation of the routes that remain open
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
£1,750 plus VAT
- The evidence prepared before the mediation
- Representation at the mediation itself
- An independent view on whether what is offered serves the person
- 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
£4,800 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 CHC mediation
Mediation only helps if the evidence is clear before you walk in.
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.
Honest advice on the route
Mediation is not right for every case. We tell you honestly whether to accept the offer or press on with the appeal.
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.
A family and their Integrated Care Board had been arguing for months about a father's night-time needs. Nobody disputed what the care home's records said; the dispute was about what they meant. When the ICB offered mediation as part of local resolution, the family were wary of walking into a room of professionals unrepresented.
A registered professional prepared before anyone sat down: the records mapped to the twelve care domains, the points of genuine dispute separated from the noise, and the family clear about what a good outcome would look like. At the mediation, the social worker kept the discussion anchored to the National Framework rather than impressions.
The meeting ended with an agreement, recorded in writing, that the night-time evidence would go before a fresh review. Mediation did not decide eligibility, and it gave up none of the family's appeal rights. It moved a stuck case forward without another year of correspondence.
Mediation only works if there is something to mediate between. Two readings of the same care plan is not that. An independent assessment of what the person needed, carried out by a registered professional and set against the Integrated Care Board’s own scoring, gave the meeting an actual difference to resolve.
This is an illustrative example. It does not describe any individual client.
How mediation works in practice
Frequently asked questions
Frequently Asked Questions About CHC Mediation
What is mediation in a CHC case?
A structured conversation between the family and the Integrated Care Board, aimed at resolving a Continuing Healthcare dispute without going further through the appeal process. It works best where the disagreement is about how the evidence has been read rather than about missing evidence.
Is mediation always available?
No. Mediation sits within local resolution arrangements and it is offered at the Integrated Care Board's discretion, so availability varies from board to board. Where it has not been offered, we can ask for it where the case suits it, and where it is not available the appeal routes remain the way forward.
Do we lose our appeal rights by mediating?
No. Mediating does not give up any appeal rights. If mediation resolves the dispute, the agreement is recorded in writing. If it does not, the case continues through local resolution and, where needed, to the NHS England Independent Review Panel.
What does the fee include?
The fee of £1,750 plus VAT covers the evidence preparation, representation at the mediation and the written record of the outcome, with peer review throughout. Travel for in-person attendance is the only possible addition and is confirmed in writing before booking.
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.
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.
Supporting guidance
Related NHS Continuing Healthcare guides
Independent Social Care Needs Assessment & Care Plan
Included in the new client price of every CHC service and charged once. Independent needs assessment and written care plan, also available on its own.
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.
Other CHC support stages
Discuss your case
Been offered mediation?
Contact Nellie Supports to discuss CHC mediation representation. We will confirm whether mediation is the right route, the fee and the next steps in writing.
Written by Ben Slater, Founder and Managing Director, Nellie Supports. Read our editorial policy.