It can take several weeks from start to finish. The guidance provides that a full assessment of eligibility should take place no later than 28 days from the date of the positive NHS Checklist screening tool.

It depends on the cost of care during the eligible period. Our leading expert, James Urquhart-Burton, has recovered over £350,000 in wrongly paid fees and interest for one family alone.

We usually work on a time-spent basis, so you only pay for the support you use. We provide clear fee estimates in advance, with no hidden costs.

The National Framework for Continuing Healthcare indicates that, where an individual has been found eligible, a review should be undertaken within three months of the eligibility decision. After that, further reviews should be undertaken annually, or more frequently in line with clinical judgment and changing needs.

These reviews should primarily focus on whether the care package remains appropriate to meet the individual’s needs (as opposed to a reassessment of eligibility). However, if the NHS consider it necessary to re-assess eligibility, then it will need to arrange for a multi-disciplinary team (MDT) to complete a Decision Support Tool (DST) and make a new eligibility recommendation.

We can assess the merits of your appeal to advise you whether it is worth appealing. The CHC process is complex, But with expert guidance, you have the best chance of securing a fair outcome.

Yes. NHS Continuing Healthcare can cover the cost of care in both care homes and at home. What’s important is that the individual’s needs were intense, complex or unpredictable.

We don’t use generic templates, each case is unique. Instead, we help you build a personalised, persuasive argument based on your specific care needs and evidence.

You may register an appeal against a decision of ineligibility. In England, this must usually be presented within 6 months of the decision.

It covers the full cost of the care package, so if the care is provided in a nursing or residential home, for instance, it would cover all the care home fees.

Medical records, care home notes, risk assessments, and daily care logs can all potentially help demonstrate the complexity and intensity of your loved one’s needs. We can help you gather and organise this information so that it supports your appeal effectively.

If the decision follows on from a full eligibility assessment, you can appeal. In cases where there are procedural concerns and there is an argument that your relative meets the criteria, it’s important to challenge. We support you through the entire process, including NHS England’s Independent Review Panel if needed.

This is any past period where the NHS didn’t check if someone was eligible for Continuing Healthcare. If that happened, you may be able to reclaim care fees.

It is a concept developed by the Department of Health and Social Care to assist in the determination of eligibility for NHS Continuing Healthcare. According to the National Framework for Continuing Healthcare Funding and NHS-funded Nursing Care, the Nature, Intensity, Complexity, and/or Unpredictability of your needs may indicate a Primary Health Need.

This is the first step in appealing a CHC funding refusal. It’s a chance to meet with the NHS Integrated Care Board (ICB) and challenge their decision before going to an Independent Review Panel.

It’s a care package fully funded by the NHS for people with serious ongoing health needs. It covers care home fees, nursing care, and support at home.

CHC is a fully funded healthcare package provided by Integrated Care Boards on behalf of the NHS for individuals who are assessed as having a Primary Health Need due to significant, ongoing healthcare needs.

FNC is a financial contribution by the Integrated Care Board towards the cost of care and the cost of nursing care for those in a nursing home. It is an acknowledgement that you have nursing needs, but that they are incidental to your social care need. Unlike Continuing Healthcare Funding, which pays 100% of the care costs of those people who are assessed as having a Primary Health Need.

Data from NHS England shows that only around 13% to 25% of appeals are overturned at Local Dispute Resolution. This data will include appeals brought by a variety of people. It’s really important to get realistic advice about your prospects, and to ensure the appeals process is fully exhausted to Independent Review Panel, where there is merit in doing so. Success will also depend on how well your case is presented.

The Checklist is the first step in the CHC process. It’s a screening tool used to decide if a full assessment is needed. Many cases fail here, but we help you prepare.

CHC is for people with significant healthcare needs, whereas local authority funding is typically for social care needs and may involve a means test.

Someone such as a nurse or social worker will complete the Department of Health and Social Care’s NHS Checklist tool to screen the individual’s needs, determining whether a full eligibility assessment is needed. If it is, then a multi-disciplinary team (MDT), best comprising a combination of health and social care professionals, will complete the Decision Support Tool (DST) to obtain further information about the individual’s needs, before making a recommendation to the Integrated Care Board about their eligibility.

You’ll usually need the Decision Support Tool (DST), outcome letter, and any meeting notes or reports. You may also wish to obtain clinical or witness evidence. Here at Winston Solicitors, we will guide you on what’s needed at every stage.

Charities can provide free information, and for more direct help, organisations. Or law firms, such as Winston Solicitors, can help you.

Local Dispute Resolution happens with your local NHS team. If that doesn’t resolve things, you can ask NHS England to set up an Independent Review Panel.