Were you denied CHC funding you should have received? You may be entitled to significant reimbursement.
If you or a loved one paid for care that should have been funded by the NHS, a retrospective claim could recover thousands—sometimes hundreds of thousands—of pounds in care fees. Retrospective claims allow families to reclaim funding for periods where an individual should have been assessed for NHS Continuing Healthcare but was not.
Why pursue a retrospective claim?
The NHS has a legal obligation to fund care for individuals with a primary health need. When assessments are missed or never conducted, families are left paying for care that should have been fully funded. Retrospective claims exist to correct these failures, but they require robust evidence, expert advocacy, and realistic expectations about the likelihood of success.
What is a retrospective CHC claim?
The NHS calls it a 'Previously Unassessed Period of Care'. It's a claim for backdated NHS funding to cover periods where someone should have been entitled to Continuing Healthcare funding but was never assessed at the time.
You can claim for individuals who are still alive, or on behalf of those who have died if you are the executor or administrator of the estate.
How far back can I claim CHC Funding?
Your claim can go back to 1 April 2012.
How much could I recover?
If successful, you would recover care fees paid during the period where you should have received CHC funding. This can be a significant reimbursement depending on the length of the claim:
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12 months of care: Average refund of £67,496
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5 years of care: Average refund of £337,480
(Based on 2025 average weekly care home cost of £1,298)
Understanding Your Claim: Eligibility, Evidence, and Realistic Outcomes
What are my chances of success?
Let's be honest: retrospective CHC claims are difficult.
Retrospective funding will not be awarded for individuals who had only social care needs. The assessment process is designed to determine whether the individual had a 'primary health need', needs over and above those which can be met by the Local Authority.
When the deadline passed for pre-2012 retrospective claims, the data revealed just how challenging these cases are:
85% of claims were deemed ineligible
5% received partial funding
10% received full CHC funding
These statistics reflect the difficulty in building a strong case, but also the widespread misinformation at the time. Many families were encouraged by unethical companies to 'recover all care fees paid' and pursue claims with no realistic prospect of success.
We will always provide honest advice about the merits of your claim and whether a retrospective claim should be pursued.
Am I eligible for a retrospective CHC claim?
If the individual was not assessed for CHC during the period in question, and they funded their own care (in part or in full), they will be eligible to request a retrospective assessment.
However, you cannot claim retrospectively if:
The individual was considered for a CHC checklist
They underwent a full assessment for CHC
They received Funded Nursing Care, with regular reviews also considering CHC eligibility
If any formal CHC consideration took place during the period you wish to claim for, that period cannot be reassessed retrospectively.
How can Nellie Supports help?
The first step in any retrospective CHC claim is a review to determine the extent of your claim and the merits of pursuing a case.
Whilst we can never guarantee funding, we provide expert advice and advocacy to build your case. We will always provide clear and honest advice so you can make an informed decision.
Our services include:
Free 15-minute consultation
A no obligation initial chat to ask any preliminary questions and provide some background information about your case.
Initial Review
A desktop and/or telephone review of your case to determine whether a full claim could be submitted. This assessment will not involve a review of all care and medical records at this stage, but will be based on a review of key records only and a detailed telephone consultation.
Evidence is everything
Without detailed care, medical and supporting records demonstrating an individual's needs over the relevant period, the likelihood of a successful claim will be slim.
You must gather records at the earliest opportunity.
The strength of your retrospective claim depends entirely on the quality and comprehensiveness of the evidence you can provide. This includes:
Care home records and care plans
Medical records from GPs, hospitals, and specialists
Medication records
Nursing notes and daily care logs
Any assessments conducted during the period (even if not CHC-related)
The more detailed the records, the stronger your case. Missing or incomplete documentation significantly reduces the chances 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.
Ready to explore your claim?
If you believe you or a loved one should have been assessed for NHS Continuing Healthcare but were not, we can help you understand whether you have a case worth pursuing.
We'll never waste your time or money on a claim that won't succeed. Our approach is built on honest advice, robust evidence, and realistic expectations.
Book your free 15-minute consultation today.
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 Retrospective
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 Retrospective CHC Questions Answered
The process can be lengthy. Once all evidence has been submitted, ICBs should aim to complete the assessment within 28 days, but in reality it often takes significantly longer—sometimes several months or even over a year, depending on the complexity of the case and the ICB's workload.
Yes. If you are the executor or administrator of the estate, you can submit a retrospective claim on behalf of someone who has passed away. Any reimbursement awarded will be paid to the estate.
Yes. If your claim is successful, the ICB must reimburse care fees paid plus compound interest. Interest is typically calculated using the Retail Price Index (RPI) from the date fees were paid. The interest element can add a substantial amount to the final reimbursement.
If your claim is unsuccessful, you have the right to request an Independent Review Panel (IRP) to review the decision. You must submit your appeal within 6 months of the decision. Expert representation significantly improves the chances of a successful appeal.
You are responsible for gathering and submitting evidence to support your claim. This includes care home records, medical records, GP notes, medication records, and any assessments conducted during the period. The ICB will not gather this evidence for you—the burden of proof lies with the claimant.
Generally, no. If the individual received Funded Nursing Care and was regularly reviewed for CHC eligibility during that period, those periods cannot be retrospectively reassessed. However, if no CHC consideration took place alongside FNC, there may be grounds for a claim.
If care fees were paid using proceeds from the sale of property or other assets, and the individual should have been eligible for CHC funding, you can still claim retrospectively. The reimbursement would cover the fees paid during the eligible period, regardless of how those fees were funded.
Costs vary depending on the complexity and duration of the claim. At Nellie Supports, we offer a free 15-minute consultation, an Initial Review for £500 plus VAT, and full representation ranging from £3,000 to £15,000 depending on the length of the claim period and volume of evidence involved.
Missing or incomplete records significantly weaken your case. If key evidence is unavailable, it may not be possible to demonstrate that the individual had a primary health need during the period in question. We can advise on what records are essential and help you request them from care providers, but without sufficient evidence, the likelihood of success is very low.
No. The deadline for pre-2012 retrospective claims has passed. Claims can only be made for periods of care from 1 April 2012 onwards.
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 review - 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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