Nellie Supports · NHS Continuing Healthcare
CHC Review Support: Clear Evidence for Your Care Package Review
Prepare for a CHC review with a current account of the person's needs and the care meeting them. We help explain changes, ongoing interventions and needs that remain present despite effective support. £2,400 including VAT for new clients; £1,080 including VAT for eligible existing cases. We confirm assessment work and meeting attendance in your written scope. Travel is charged separately.
Service overview
Prepare for a CHC review with a current account of the person's needs and the care meeting them. We help explain changes, ongoing interventions and needs that remain present despite effective support. £2,400 including VAT for new clients; £1,080 including VAT for eligible existing cases. We confirm assessment work and meeting attendance in your written scope. 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.
Current evidence and practical support for three-month and annual CHC care package reviews.
New clients: £2,400 including VAT
Review booked: Tell us the date
Cover throughout the country: England
Registered professionals: Social work led
At a glance
Role
Independent evidence for a three month or annual CHC review
Framework
National Framework for NHS CHC and NHS-funded Nursing Care, 2022 revision
Format
Assessment at home or in the care setting, then a written evidence summary
Deliverable
A current account of needs mapped to the twelve care domains
Coverage
England only. Wales has a separate Continuing NHS Healthcare framework.
Who are you arranging this for?
We agree how the person will be involved, who can instruct us and who should receive updates.
I am supporting a family member
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.
I am instructing as a professional
We agree the instruction, authority to act, evidence required, reporting arrangements and timetable with you. Written work links each point to its source.
What CHC review support is
Nellie Supports is an independent social work practice. Our NHS Continuing Healthcare support helps families and professionals in England explain care needs and present relevant evidence.
What CHC review support is
Support to explain current needs, the care package and any changes before the CHC review.
The care package is normally reviewed within three months and then at least annually. The primary purpose is to check that arrangements meet assessed needs; a routine review should not automatically become a full eligibility reassessment.
We bring together current records, the person's experience and carer accounts, so the review can understand both the needs and the care managing them.
When you need review support
This service can help when a review is approaching, needs have changed or you want support explaining why ongoing care remains necessary.
We compare the present picture with the previous assessment and identify any gaps in the evidence or care plan. Clear evidence can support the discussion without guaranteeing a funding outcome.
A review date has arrived
Three months after the award, or annually after that.
You want to prepare for the discussion
You need to understand what the review is considering and the information to provide.
The person seems more settled
You want the records to show the continuing care behind that stability.
Needs have increased
The care plan may need updating to reflect changed support requirements.
The care provider has changed
A new provider’s records may not carry the history the review needs.
Funding was reduced at the last review
You want the next one approached differently.
What the review will look at
A routine review examines whether the care arrangements still meet assessed needs. We help explain current support, changes and whether the evidence indicates a separate full reassessment is needed.
Whether the needs themselves have changed, as opposed to the presentation
What the care package is currently doing, and what would happen without it
Day and night-time support and the interventions still required
Fluctuation and unpredictability since the last review
Incidents, admissions and near misses in the period
Whether identified changes may affect eligibility and need full reassessment
A review is not a fresh application
The starting point is whether the care arrangements meet assessed needs. A full reassessment should follow only where clear evidence of changed needs may affect eligibility, rather than being automatic at each review.
Well managed needs are still needs
Successful care does not make the underlying needs disappear. The evidence should explain the monitoring, support and interventions required to manage them, as the National Framework requires.
The framework for reviewing CHC funding
A routine CHC review primarily checks whether the care plan and arrangements still meet the person’s needs. It does not automatically require a new eligibility assessment. Where there is clear evidence of a change that may affect eligibility, the ICB should arrange a full reassessment under the National Framework.
We compare the current evidence with the previous assessment and identify any change in needs. Needs that are being successfully managed must still be recognised. If eligibility is reassessed, the evidence must address the primary health need test and support the reasons for the decision.
Framework: National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (2022 revision); the primary health need test; Integrated Care Board review and decision-making
Read the supporting guidance
Whether the current care plan meets the person’s needs
Changes identified against the previous assessment
Needs that remain present despite effective care
Whether the evidence calls for a full eligibility reassessment
Our review process
Initial enquiry and triage
Tell us the review date, who is coordinating it and any proposed change to the package or eligibility. We confirm the appropriate service and timetable.
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 assessment
We agree the current assessment and records work needed, involving the person and relevant carers with suitable participation arrangements.
The evidence written up
Needs are written up against the twelve care domains, showing what the package is managing and what the risk is without it.
Into the review
We prepare the agreed written evidence and provide meeting support where included in your scope. We explain the outcome and any separate review or reassessment step.
What we look at
We consider the period since the previous decision, alongside the earlier assessment needed to understand what has changed.
Time with the person
Where they live, at their pace, seeing the day as it actually runs.
Current care records
Daily notes, charts and handovers since the last review.
The people providing the care
Family carers and care staff who know what a bad night looks like.
Incidents and admissions
Falls, choking, infections, hospital episodes in the period.
The existing care plan
What it says, and where it has fallen behind the person.
The original decision
The domain levels awarded, and whether the records still support them.
What you receive
Your agreed scope identifies the assessment, evidence and meeting support included.
A current independent assessment of day-to-day needs
Needs mapped to the twelve care domains
What the care package is managing, and the risk without it
A written care plan where required for the agreed package
Relevant screening evidence where needed within scope
A clear account of the evidence and its limits
Two prices, depending on whether we already have your case
£2,400 including VAT for new clients, with the assessment and care plan specified in the package. Eligible existing cases are £1,080 including VAT. We confirm which earlier work remains suitable.
Returning clients
- A current care assessment by a registered professional
- Needs written against the twelve care domains
- The evidence prepared before the review meeting
- Attendance within the meeting arrangements and agreed scope
- Relevant screening evidence where needed within scope
£1,080 including VAT
New to Nellie Supports
- Everything in the returning price
- A written care plan alongside the current care assessment
- Assessment updates included for the same person and continuing case
£2,400 including VAT
Fees
New clients: £2,400 including VAT
£2,400 including VAT for new clients; £1,080 including VAT for eligible existing cases. Your written scope confirms the current assessment, care plan, evidence work and attendance included, together with any additional costs. A later appeal is separately agreed.
Fee confirmed in writing
The total fee including VAT, scope and any additional attendance costs are agreed before instruction.
Assessment by a registered professional
The person seen, the records read, the carers asked.
Evidence in the language of the domains
The evidence explains needs and interventions relevant to the care package and any proposed reassessment.
Relevant screening evidence
Included where required within the agreed review scope.
Evidence and reasons explained
The written work identifies the records used, the reasons for our view and any gaps that could affect it.
No percentage, ever
We take no share of any funding retained or recovered.
How review support works in practice
A family is preparing for an annual review. Their relative is more settled, but continues to need the same monitoring and support.
The family wants the review to understand the ongoing care that has made the person more stable.
In this example, we would compare current records with the earlier assessment and explain the interventions still required, alongside any genuine changes.
The family would have a clear account for the review. Any separate eligibility reassessment would remain an NHS decision under the National Framework.
Illustrative example only. This does not describe a client or predict an NHS or Ombudsman decision.
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 written work identifies the records used, the reasons for our view and any gaps that could affect it.
A reasoned next step
We explain where the evidence does not support further work and what other route may be relevant.
Why choose Nellie Supports for a CHC review
We connect current care needs, records and the earlier assessment so the review has a clear account of changes and continuing support.
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.
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.
We write our own assessments
Our independent account complements the existing records and explains any material differences in the evidence.
Published fees, never a percentage
Your scope and total fee including VAT are confirmed before instruction. Additional work is agreed before it starts.
A clear point of contact
A named contact helps you understand the agreed work, the information needed and the next step.
Written work you can follow
The written work identifies the records used, the reasons for our view and any gaps that could affect it.
Honest about outcomes
The review decision is the Integrated Care Board’s. We never promise a result.
Frequently Asked Questions About CHC Reviews
Can NHS funding really be taken away at a review?
A routine review checks the care package and should not automatically reopen eligibility. Where clear evidence of changed needs may affect eligibility, the ICB should arrange a full reassessment before making that decision.
They said the review is just a formality. Is it?
A review is worth preparing for, but its main purpose is to check the care arrangements. Ask what will be considered, provide relevant current evidence and clarify whether a separate reassessment is proposed.
He is much better than last year. Does that mean he will lose it?
Improvement does not automatically end eligibility. Needs successfully managed by ongoing care remain needs. The evidence should explain both any genuine change and the interventions still required.
What if the review goes against us?
Ask for the written outcome and reasons. A package concern and a decision that eligibility has ended may require different NHS routes. We explain the relevant next step and any deadline.
Do you attend the review meeting?
Attendance depends on the NHS arrangements and the service you instruct. Tell us the meeting date so we can confirm attendance, format and any additional costs before booking.
Related NHS Continuing Healthcare guides
The NHS Continuing Healthcare process explained
A plain English guide to the Checklist, the Decision Support Tool, the MDT and the ICB decision.
The Decision Support Tool and the 12 care domains
How the DST scores needs and why the domain language matters.
Challenging a CHC decision
What a decision letter means, and the routes open to you afterwards.
Other CHC support stages
If the review has already gone against you, our team supports the stages that follow.
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.
Is a review coming up?
Tell us when the review is, what has changed since the last one and who is carrying out the assessment. We will confirm the right level of support and the fee in writing.
Tell us about any urgent date at first contact so we can confirm whether the required timetable can be met.