Support for Professional Deputies – Continuing Healthcare Funding and Appeals
The impact of Re ACC continues to have far-reaching consequences for professional deputies and the vulnerable people they support. The case determined that CHC appeals are considered ‘litigation’, meaning deputies can no longer challenge funding decisions without first obtaining court approval, a process that is both costly and time-consuming.
How should Deputies approach CHC claims?
Deputies have a duty to explore and secure public funding for their clients where appropriate. Professional deputies, held to a higher standard, are expected to have good working knowledge of the support available. As the hurdles following Re ACC make it increasingly difficult for deputies to challenge CHC decisions, the emphasis should shift towards ensuring CHC assessments are accurate from the outset.
Representation and support in the early stages can help prevent costly appeals further down the line.
Our Services - Clear and Fixed Costs
We believe in transparency. Every service comes with a fixed price, so you'll always know the cost upfront.
Consultation - £250 plus VAT
A consultation with our specialist CHC solicitor to review your client’s case. This can be over the phone, or a paper review, to investigate your client’s needs and determine whether a new claim for CHC should be pursued.
Full Assessment (DST Meeting) Representation
DST meetings are often conducted hastily, and entitlement can be missed. Early-stage support can be crucial to help secure funding at the first opportunity and avoid the need for costly appeals. Our representation service includes:
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Comprehensive preparation for the DST meeting, including a full review of care records and supporting evidence.
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Attendance and representation at the DST meeting, either in person or via video link, to advocate for your client and ensure the meeting is carried out thoroughly and in accordance with the National Framework.
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If there are issues or concerns with the conduct or outcome of the DST meeting, we can provide a written report to support an application to court for permission to appeal (£250 + VAT, if required).
Full Assessment (Decision Support Tool) Review
If a full assessment has been completed and you are uncertain whether to pursue an appeal, our DST Review Service offers:
• A comprehensive review of the DST outcome and all supporting care and medical records.
• A detailed written report outlining the assessment findings, highlighting any errors or inconsistencies, and providing our professional opinion on the merits of pursuing an appeal.
• Support with drafting your COP24 statement should court permission to appeal be required (£250 + VAT, if applicable).
Formal Appeals and Representation
Appeal Stage Two - Independent Review Panel Representation - £9,000 + VAT
If you've already paid for DST Representation / Review (£2,000), we'll deduct this from your appeal cost.
What we offer: Comprehensive support in preparing and presenting your case at the second stage of the appeals process. This is a formal review of the ICB's decision at a panel hearing. Our service includes gathering and analysing evidence, preparing submissions, and representing you during the hearing.
When: If your CHC application has been refused at both the Checklist/DST stage and the local resolution appeal, and you wish to escalate your case to the national review stage. The IRP is often the final opportunity to secure NHS Continuing Healthcare funding before referring to the Parliamentary and Health Service Ombudsman.
Why us: The IRP process can feel daunting, but with the combined expertise of our legal, psychological, and social care professionals, you can be confident your case is argued with both legal precision and a deep understanding of care needs.
Appeal Stage One - Local Resolution Support - £8,000 + VAT
If you've already paid for DST Representation / Review (£2,000), we'll deduct this from your appeal cost.
What we offer: Comprehensive support in this first stage of the appeals process. We will gather and review evidence, prepare your case and represent you at the resolution meeting with a view to challenging the decision which has been made.
When: After your CHC application has been refused, downgraded, or assessed unfairly, and you wish to challenge the outcome. Engaging support at this stage ensures your appeal is well-prepared and supported from the outset.
Why us: Appeals can be complex and emotionally draining, but families frequently succeed when supported by experienced professionals who understand both the legal framework and the care context giving your challenge the strongest possible chance of success.
Appeal Stage Three - Ombudsman Support - £8,000+ VAT
If you've already paid for DST Representation / Review (£2,000), we'll deduct this from your appeal cost.
What we offer: Specialist support in preparing and submitting your case to the Parliamentary and Health Service Ombudsman (PHSO). Our team reviews every stage of your CHC journey, identifying any errors in law, fact, or process, and preparing a clear, evidence-based submission explaining why the decision should be reconsidered.
When: After your case has been heard by the Independent Review Panel (IRP) and the decision has been upheld, but you believe the process was unfair, flawed, or procedurally incorrect. The Ombudsman is the final stage in the appeals process.
Why us: The Ombudsman stage is complex and highly procedural, requiring detailed knowledge of both law and care practice. Our multidisciplinary team ensures your submission is meticulously prepared and supported by strong legal and clinical reasoning, giving your case the best possible chance of success.
Travel Charges
All travel undertaken as part of service delivery is chargeable at £40 per hour. This includes time spent travelling to and from appointments, meetings, or assessments. Travel time is calculated based on the most efficient reasonable route.
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.
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).
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Attorneys and Deputies have a duty to act in the best interests of the person they represent.
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Provided the cost is reasonable and affordable, using their funds to cover professional advice on CHC is acceptable.
We also provide mental capacity assessments for other decisions, including COP3 assessments and LPA capacity assessments. For complex cases, our advanced mental capacity assessment service provides comprehensive support. If you need assistance with NHS Continuing Healthcare appeals or care funding disputes, we can help
Expert Insights on
NHS Continuing Healthcare (CHC)
Explore our articles on CHC applications and appeals, with practical guidance, real-world examples, and expert insights. Written to help families, solicitors, and deputies better understand the process and feel more confident at every stage.
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:
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Medical records and health assessments
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Social care assessments and reports
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Medication lists and prescriptions
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Care needs documentation
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Letters from healthcare professionals (GP, consultant, nurse)
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Photographs or videos showing care needs (if appropriate)
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Diary entries documenting daily care requirements
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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.
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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)
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Chartered Psychologists (HCPC registered)
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SRA-Regulated Solicitor (professional legal representation)
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Healthcare Specialists (including a forensic scientist for complex cases)
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.
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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
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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.
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Our initial consultation is one hour and costs £250 + VAT. During this time, we will:
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Review your situation in detail
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Explain the CHC process in plain English
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Discuss your options at each stage
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Provide tailored advice based on your circumstances
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Explain what evidence matters
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Outline next steps and realistic timelines
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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.
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Yes. The CHC appeals process has three stages:
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Local Resolution - First appeal to your ICB/LHB (typically 3 months)
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Independent Review Panel (IRP) - If Local Resolution is unsuccessful (typically 3 months)
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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.
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Initial CHC Consultation (£250 + VAT):
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One-hour expert review
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Plain English explanation of the CHC process
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Tailored advice on your options
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Guidance on evidence and documentation
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Written summary of recommendations
CHC Checklist Support (£495 + VAT):
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Comprehensive care needs assessment
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Prospective CHC Checklist completion
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Evidence-based documentation
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Professional recommendations on eligibility
DST Representation (£2,000 + VAT):
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Preparation for DST meeting
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Evidence review
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Professional representation at the meeting
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Legal precision and care expertise combined
CHC Decision Review (£2,000 + VAT):
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Comprehensive review of your decision letter
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Identification of errors or gaps
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Written opinion on grounds for appeal
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Guidance on next steps
Appeal Stage One - Local Resolution (£8,000 + VAT):
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Full representation through the appeals process
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Evidence gathering and analysis
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Written submissions
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Negotiation with your ICB/LHB
Appeal Stage Two - IRP Representation (£9,000 + VAT):
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Professional representation at IRP hearing
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Expert advocacy
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Written submissions
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Cross-examination support
Appeal Stage Three - Ombudsman Support (£8,000+ + VAT):
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Representation through Ombudsman process
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Complaint documentation
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Liaison with the Ombudsman
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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)
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Plus care expertise (our registered social workers and psychologists)
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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.
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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
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We're not constrained by NHS institutional bias
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We can identify gaps in how your case was assessed
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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.
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Getting started is simple:
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Book a free 15-minute call - Talk through your situation with no obligation
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Arrange a consultation (£250 + VAT) - Detailed review and tailored advice
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Choose a service - Based on your needs and our recommendations
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We support you - Through every stage of your journey
You can book online, call us on 0333 987 5118, or email Nellie@nelliesupports.com.
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We understand that families facing CHC funding issues may be under financial strain. Here's what we recommend:
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Start with a free 15-minute call - Discuss your situation at no cost
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Consider our Initial Consultation (£250 + VAT) - This gives you expert guidance on whether an appeal is realistic before committing to full services
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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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