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Est. 2019

NHS Continuing Healthcare (CHC) — Structured Evidence & Representation

Most NHS Continuing Healthcare cases do not fail because there is no evidence - they fail because the evidence is fragmented, inconsistent, or not clearly mapped to the Decision Support Tool (DST).

Our approach is different.

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We prepare a professionally structured CHC evidence bundle designed to withstand scrutiny at MDT, panel and appeal stages - ensuring the full picture of need cannot be minimised or overlooked.

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Been Refused NHS Continuing Healthcare?
You usually have 6 months to appeal.


→ Challenge a CHC Refusal

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Where We Step In

Families contact us when:

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  • A Checklist has not progressed

  • A DST meeting is approaching

  • A decision has been refused

  • The evidence does not reflect the reality of care needs

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Our role is not simply to attend meetings - it is to ensure the evidence underpinning your case is robust, coherent and precisely aligned with the CHC criteria.

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Why CHC Cases Fail

CHC decisions are based on how clearly evidence supports the criteria of:

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  • Nature

  • Intensity

  • Complexity

  • Unpredictability

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Even extensive records can fail to demonstrate eligibility if:

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  • Care notes are disorganised

  • Incidents are not cross-referenced

  • Risks are not analysed

  • DST domains are not clearly evidenced

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Find out what to expect at a DST meeting here

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Volume does not win CHC cases. Structure does.

The One-Stop CHC Evidence Pack 

​A solicitor-led, professionally structured CHC evidence bundle built once and used throughout the process.

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  • Strengthen eligibility at MDT stage

  • Support representation

  • Remain usable at appeal

  • Avoid rebuilding evidence repeatedly

External Care Records Collation

All relevant health and care records are collected, reviewed and organised into a single, professionally structured bundle. Records are ordered, de-duplicated and prepared so they can be relied upon by the MDT or panel.

Evidence Register

A master index of all evidence included in the pack. Each document is logged, referenced and cross-linked to the DST Evidence Map, ensuring the bundle is easy to navigate and can be updated without losing coherence.

Care Diary Pack

Structured care diary templates and guidance to capture day-to-day needs, incidents, night-time disruption and supervision requirements over a defined period. This converts lived experience into usable CHC evidence.

Care Needs Assessment

An independent social care assessment completed by our own qualified assessment team. The assessment is written specifically in CHC language and focuses on care needs, supervision and risk beyond what would be expected under social care alone. 

Care Plan

A clear, evidence-based care and support plan prepared by our in-house practitioners. The plan sets out the level of care and supervision required, including frequency and intensity of support, night-time needs, monitoring arrangements and how care must escalate when risks increase.

DST Evidence Map

A domain-by-domain evidence grid aligned to the Decision Support Tool (DST). Each domain is mapped to the exact evidence that supports it, including document references and page numbers, so any representative can easily locate and rely on the evidence during the MDT.

Executive Summary

A concise overview explaining why CHC applies overall. It sets out the key risks, highest-impact needs, and how the person meets the CHC criteria of Nature, Intensity, Complexity and Unpredictability, with clear references to supporting evidence.

Transparent, Fixed-Fee Structure

We operate a clear, stage-based pricing model so you understand your costs before any work begins.

Care Funding Consultation and Action Plan

£395.00

CHC Checklist Readiness and Advocacy Letter

£395.00

DST Viability Review 

£290.00

DST Attendance and Representation*

£750.00

Appeal Viability Review**

£2000.00

Local Resolution Submission and Attendance *

£1000.00

One -Stop Evidence Pack

£3000.00

Prices are exclusive of VAT and travel. * Requires One-Stop Evidence Pack ** Free if we have represented you at DST Terms and conditions apply.

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A Note On Fees

If you are acting as a financial attorney under a Lasting Power of Attorney (LPA), or as a Deputy appointed by the Court of Protection, you may usually use the funds of the person you support to pay for our services.

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This is because:

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  • The advice is being sought on their behalf (the person who may be entitled to NHS Continuing Healthcare funding).

  • Attorneys and Deputies have a duty to act in the best interests of the person they represent.

  • Provided the cost is reasonable and affordable, using their funds to cover professional advice on CHC is acceptable.

Solicitor-Led CHC Representation

Our NHS Continuing Healthcare work is solicitor-led, ensuring that every stage of your case is prepared with both clinical understanding and legal precision.

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We focus on:

  • Care needs analysis grounded in the National Framework

  • Risk identification and escalation

  • Clear application of the Primary Health Need test

  • Domain-by-domain DST scrutiny

  • Procedural fairness at appeal and review stages

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This ensures your evidence is not only comprehensive, but structured in a way that withstands scrutiny at MDT, panel and Independent Review Panel level.

Your Continuing Health Care Questions Answered

  • NHS Continuing Healthcare is a package of care that is fully funded by the NHS for people with significant ongoing health needs. It covers the full cost of care at home, in a care home, or in a hospice.

  • No. Unlike social care provided by local authorities, CHC is not means-tested. Your savings, income, or whether you own your home does not affect eligibility.

  • You must be assessed as having a primary health need, using the NHS Decision Support Tool (DST). This means your needs are mainly for healthcare, rather than social care.

  • The checklist is an initial screening tool to decide whether a full CHC assessment is needed. If the checklist indicates eligibility, you move on to the Decision Support Tool (DST) meeting.

  • A DST meeting (also called a Multidisciplinary Team meeting) is where health and social care professionals assess your relative's needs in 12 "care domains." Their recommendation goes to the ICB (England) or LHB (Wales).

  • You have six months from the decision letter to appeal. The first stage is a Local Resolution with your ICB or LHB. If unsuccessful, you can escalate to an Independent Review Panel (IRP).

  • Timelines vary. Local Resolution appeals should take around 3 months, with IRPs within another 3 months. In practice, delays are common, and cases may take many months to resolve.

  • No, we cannot guarantee that you will receive NHS Continuing Healthcare (CHC) funding and no provider can. Funding decisions are made by the NHS against national criteria set out in the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care.

  • No. Nellie Supports is not a law firm and is not regulated by the Solicitors Regulation Authority (SRA). However, our CHC services are solicitor-led, meaning an experienced solicitor oversees your case. This ensures you benefit from both legal expertise and multidisciplinary input, while fees remain transparent and fixed.

  • No. Nellie Supports does not offer no-win-no-fee arrangements. We believe this model can create uncertainty for families. Instead, we provide all our CHC services on fixed fees, inclusive of VAT, so you always know the cost in advance with no hidden charges.

  • Our CHC services are priced transparently and fixed, so you always know the cost upfront. Prices range from £250 for an initial consultation to £9,000+ for full appeal representation. Each service has a clear, fixed price with no hidden fees or surprise charges.

    You can view our full pricing on our services section above, or book a free 15-minute call to discuss which service is right for your situation.

  • Strong evidence is crucial to a successful appeal. This typically includes:

    • Medical records and health assessments

    • Social care assessments and reports

    • Medication lists and prescriptions

    • Care needs documentation

    • Letters from healthcare professionals (GP, consultant, nurse)

    • Photographs or videos showing care needs (if appropriate)

    • Diary entries documenting daily care requirements

    • Previous DST assessments or decision letters

    We can guide you on what evidence matters most for your case and help you gather and present it effectively. This is part of our consultation and appeal services.

  • We offer both options. Most of our CHC appeal support can be conducted remotely via phone or video call, which is convenient if you're unable to travel or prefer to stay at home.

    For DST meetings and some appeal hearings, face-to-face representation may be more effective. We can discuss which approach is best for your situation during your initial consultation.

    Travel is available nationwide across England and Wales. If you need us to attend meetings in person, we charge £40 per hour for travel time.

  • Our team includes:

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    • Registered Social Workers (qualified, registered with Social Work England)

    • Chartered Psychologists (HCPC registered)

    • SRA-Regulated Solicitor (professional legal representation)

    • Healthcare Specialists (including a forensic scientist for complex cases)

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    All team members have extensive experience in mental capacity assessments, social work, psychology, and legal representation. We're not just legally qualified; we understand care complexity from multiple professional angles.

  • If your appeal is unsuccessful at one stage, you have the option to escalate to the next stage:

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    • If Local Resolution is unsuccessful, you can request an Independent Review Panel (IRP) hearing

    • If the IRP upholds the decision, you can escalate to the Parliamentary and Health Service Ombudsman (PHSO)

     

    We can advise whether escalation is realistic for your case and support you through the next stage if you choose to continue. We're honest about what's achievable, so you can make informed decisions about next steps.

  • Our initial consultation is one hour and costs £250 + VAT. During this time, we will:

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    • Review your situation in detail

    • Explain the CHC process in plain English

    • Discuss your options at each stage

    • Provide tailored advice based on your circumstances

    • Explain what evidence matters

    • Outline next steps and realistic timelines

    • Answer all your questions

     

    You'll leave with a clear understanding of your position and practical next steps. There's no obligation to proceed with further services after the consultation.

  • Yes. The CHC appeals process has three stages:

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    1. Local Resolution - First appeal to your ICB/LHB (typically 3 months)

    2. Independent Review Panel (IRP) - If Local Resolution is unsuccessful (typically 3 months)

    3. Parliamentary and Health Service Ombudsman (PHSO) - If IRP is unsuccessful (typically 2-3 months)

     

    Not every case needs to go through all three stages. Many are resolved at Local Resolution with the right support and evidence. We can advise which stage is appropriate for your situation.

  • Initial CHC Consultation (£250 + VAT):

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    • One-hour expert review

    • Plain English explanation of the CHC process

    • Tailored advice on your options

    • Guidance on evidence and documentation

    • Written summary of recommendations

     

    CHC Checklist Support (£495 + VAT):

    • Comprehensive care needs assessment

    • Prospective CHC Checklist completion

    • Evidence-based documentation

    • Professional recommendations on eligibility

     

    DST Representation (£2,000 + VAT):

    • Preparation for DST meeting

    • Evidence review

    • Professional representation at the meeting

    • Legal precision and care expertise combined

     

    CHC Decision Review (£2,000 + VAT):

    • Comprehensive review of your decision letter

    • Identification of errors or gaps

    • Written opinion on grounds for appeal

    • Guidance on next steps

     

    Appeal Stage One - Local Resolution (£8,000 + VAT):

    • Full representation through the appeals process

    • Evidence gathering and analysis

    • Written submissions

    • Negotiation with your ICB/LHB

     

    Appeal Stage Two - IRP Representation (£9,000 + VAT):

    • Professional representation at IRP hearing

    • Expert advocacy

    • Written submissions

    • Cross-examination support

     

    Appeal Stage Three - Ombudsman Support (£8,000+ + VAT):

    • Representation through Ombudsman process

    • Complaint documentation

    • Liaison with the Ombudsman

  • We're not a traditional law firm. We're a multidisciplinary team that combines legal expertise with social work and psychology.

    This means:

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    • You get legal representation (our SRA-regulated solicitor)

    • Plus care expertise (our registered social workers and psychologists)

    • Plus understanding of the person behind the decision (not just the legal framework)

     

    Traditional solicitors focus on legal arguments. We focus on both legal precision and genuine care insight. This integrated approach often leads to better outcomes because we understand both the law and the care complexity.

    Our fixed pricing also means you know the cost upfront, unlike many law firms which charge hourly rates.

  • Yes, completely. We're an independent professional practice, not part of the NHS system. This means:

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    • We can provide objective assessment and guidance

    • We're not constrained by NHS institutional bias

    • We can identify gaps in how your case was assessed

    • We can provide honest professional opinion focused on your family's interests

     

    Our independence is one of our key strengths. We're here to advocate for your loved one's needs, not to defend NHS decisions.

  • Getting started is simple:

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    1. Book a free 15-minute call - Talk through your situation with no obligation

    2. Arrange a consultation (£250 + VAT) - Detailed review and tailored advice

    3. Choose a service - Based on your needs and our recommendations

    4. We support you - Through every stage of your journey

     

    You can book online, call us on 0333 987 5118, or email Nellie@nelliesupports.com.

  • We understand that families facing CHC funding issues may be under financial strain. Here's what we recommend:

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    1. Start with a free 15-minute call - Discuss your situation at no cost

    2. Consider our Initial Consultation (£250 + VAT) - This gives you expert guidance on whether an appeal is realistic before committing to full services

    3. Explore our Nellie+ plans - We offer monthly support plans (£39, £199, £399) that include free initial assessments and CHC checklists

     

    If cost is a concern, discuss this during your free call. We can help you understand your options and what's realistic for your situation.

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