NHS Continuing Healthcare
CHC Mediation: Representation Where the ICB Offers It
Prepared, represented and properly recorded mediation with the Integrated Care Board, across England
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 social worker prepares the evidence, represents the family in the mediation itself, and makes sure any resolution is recorded properly. The fixed fee is £1,750 plus VAT.
£1,750
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 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.
The framework mediation sits within
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.
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.
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); ICB local resolution procedures; the primary health need test
For more, read our guide: Challenging a CHC decision
Our support process
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 fixed fee
We confirm the scope, the fixed fee plus VAT and any travel charge, in writing before you commit to anything.
Evidence preparation
A registered social worker 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 social worker 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 you receive
Support is practical and evidence led. You receive:
An evidence summary mapped to the twelve care domains
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Representation at the mediation by a registered social worker
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A properly recorded written outcome
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A written explanation of the routes that remain open
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Fees
£1,750 plus VAT
Mediation representation £1,750 plus VAT, fixed, where the ICB offers mediation. Travel for in-person attendance 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.
Evidence prepared
The records mapped to the domains before anyone sits down.
Representation at the mediation
A registered social worker in the room, on your side.
Outcome properly recorded
Agreements recorded in writing so they stick.
How mediation works in practice
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 social worker 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.
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.
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.
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 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 fixed fee include?
The fixed 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.
Related NHS Continuing Healthcare guides
Challenging a CHC decision
The NHS Continuing Healthcare process explained
CHC eligibility and primary health need
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 Application
CHC Appeal Support
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.
Been offered mediation?
Contact Nellie Supports to discuss CHC mediation representation. We will confirm whether mediation is the right route, 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.