NHS Continuing Healthcare
CHC Ombudsman Referral: When the Process Itself Failed
Structured, evidenced referrals to the Parliamentary and Health Service Ombudsman for CHC process failures
The Parliamentary and Health Service Ombudsman is the final port of call when the NHS Continuing Healthcare process itself has failed: unreasonable delay, procedural failure or maladministration that the appeal stages have not put right. We prepare and submit a non-funding referral: a structured complaint about how the process was handled, with the evidence organised so the Ombudsman can act on it. The fixed fee is £2,500 plus VAT.
£2,500
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 a referral is the right route
The Ombudsman comes into play when the appeal stages are exhausted or the failure is about process rather than eligibility: months of unreasonable delay, assessments that ignored the National Framework, or complaints that went unanswered. The referral asks the Ombudsman to investigate how the case was handled.
This is a non-funding referral: the Ombudsman does not award CHC funding, but its findings can require the NHS body to put things right, apologise, and remedy the injustice the failure caused, which can include recommending the case is reconsidered properly.
What the Ombudsman can look at
The Parliamentary and Health Service Ombudsman investigates complaints about maladministration in NHS processes, including how an NHS Continuing Healthcare case was handled. It is not another appeal about eligibility; it examines whether the process was conducted properly and fairly.
The Ombudsman looks for maladministration: what should have happened under the National Framework, what actually happened, and the injustice that followed. A referral succeeds on an organised, evidenced account of that gap, not on repeating the eligibility argument.
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: Parliamentary and Health Service Ombudsman remit; National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (2022 revision); NHS complaints procedures
For more, read our guide: The Ombudsman and CHC complaints
Also see: Challenging a CHC decision
Our support process
Initial enquiry and triage
Contact us by phone, email or website form. We review what has happened and confirm within one working day whether an Ombudsman referral is the right route.
Scope and fixed fee
We confirm the scope, the fixed fee plus VAT and any travel charge, in writing before you commit to anything.
The chronology of failure
A registered social worker builds the chronology of what should have happened under the National Framework, what actually happened, and the injustice the failure caused.
Drafting and submission
The referral is drafted in the structure the Ombudsman works to, with the evidence organised and cross-referenced, and agreed with you before it is sent.
After the referral
We explain the Ombudsman's response and findings, and what they mean for the case, in plain English.
What you receive
Support is practical and evidence led. You receive:
A clear chronology of what went wrong, mapped to the National Framework
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A structured referral drafted for the Ombudsman's process
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An organised, cross-referenced evidence bundle
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A written summary of the submission and what follows
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Fees
£2,500 plus VAT
Ombudsman referral support £2,500 plus VAT, fixed, for non-funding referrals about how the process was handled. 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.
The chronology built properly
What should have happened, what happened, and the injustice caused.
A referral that can be acted on
Drafted in the structure the Ombudsman works to.
Peer review as standard
A second qualified professional reviews the work before it is used.
How an Ombudsman referral works in practice
A husband had spent nearly two years trying to get his wife's Continuing Healthcare case handled properly: a review promised and never carried out, letters that went unanswered, and a complaint that was closed without addressing what he had actually raised. The eligibility arguments had run their course; the problem now was how the case had been handled.
A registered social worker built the chronology the Ombudsman needs: what the National Framework required at each stage, what actually happened, and the injustice the gap caused, from unfunded care fees to months of avoidable distress. The referral was drafted in the structure the Ombudsman works to, with every event cross-referenced to a document, and submitted with an organised evidence bundle.
The Ombudsman's findings were its own to make, and no referral can promise a particular outcome. What the referral did was turn two years of scattered correspondence into an account of maladministration that could actually be investigated.
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.
The right argument for the right forum
An Ombudsman referral is about process, not eligibility. We frame it that way, which is what gives it a chance of succeeding.
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 Ombudsman Referral
What can the Ombudsman actually do?
The Ombudsman investigates maladministration: unreasonable delay, procedural failure, ignored complaints and processes that departed from the National Framework. It can require the NHS body to apologise, put things right and remedy the injustice caused, which can include recommending a case is properly reconsidered. It does not decide CHC eligibility and does not award funding.
When is the right time to refer?
Generally after the NHS routes are exhausted: the Ombudsman usually expects the complaint to have been through the NHS body's own process, and for eligibility disputes through local resolution and the Independent Review Panel, before it will investigate. If you are unsure where your case sits, we will tell you honestly at triage.
What does a non-funding referral mean?
It means the referral is about how the process was handled rather than a claim for funding. If your aim is to overturn an eligibility decision, the appeal stages are the route for that, and we will point you to them instead. The Ombudsman route is for the failures the appeal stages cannot fix.
What does the fixed fee include?
The fixed fee of £2,500 plus VAT covers the review of what happened, the chronology, the drafting of the referral, the organised evidence bundle and submission, with peer review throughout. Travel 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.
NHS Independent Review Panel
CHC Appeal Support
Independent Social Care Needs Assessment & Care Plan
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 process itself went wrong?
Contact Nellie Supports to discuss a referral to the Parliamentary and Health Service Ombudsman. We will review whether a referral is the right route, confirm the fixed fee and set out 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.