Your Guide to Appealing an NHS Continuing Healthcare Funding Decision
If you’re appealing an NHS Continuing Healthcare decision, you’re not alone. Many families find that their loved one’s complex health needs have not been properly recognised during the initial assessment. In this guide, we’ll explain more about how you can launch an appeal.
At Winston Solicitors in Leeds, our specialist CHC solicitors help families across England understand the appeals process, prepare evidence, and challenge unfair funding decisions. We combine specialist legal expertise with compassion and clarity, guiding you through every stage.
What Is NHS Continuing Healthcare Funding?
NHS Continuing Healthcare is a package of care arranged and fully funded by the NHS for adults with significant or long-term health needs. It can cover the full cost of care, whether the person lives in a care home or receives care at home. Unlike social care, it is not based on financial means or savings.
Eligibility for CHC depends on whether a person’s care needs are primarily health-related. The assessment looks at four key factors: the nature, complexity, intensity, and unpredictability of those needs. If the care required is mainly for health reasons rather than personal or social care, the NHS may be responsible for funding.
Why CHC Applications Are Often Refused
Families are often shocked when a CHC application is rejected, especially if their loved one’s needs seem clearly severe. Unfortunately, many assessments overlook crucial evidence or fail to consider how conditions fluctuate over time.
Common reasons for refusal include:
- Limited evidence presented during the assessment, such as missing care records or incomplete reports.
- Assessors applying the eligibility criteria too narrowly or inconsistently.
Even if your application has been refused, it is important to know that this does not have to be the end of the process. You have the right to appeal, and with the right support, many families succeed at this stage.
The Process for Appealing an NHS Continuing Healthcare Funding Decision
Appealing an NHS Continuing Healthcare Funding decision involves asking for the original outcome to be reviewed. The process can be complex, but our team will guide you step by step, ensuring everything is handled correctly and efficiently.
There are usually two main stages to the appeals process:
1. Local Resolution Meeting
If your CHC application is refused, you can request a Local Resolution meeting with your local Integrated Care Board (ICB). This meeting gives you the opportunity to explain why you disagree with the decision and present additional evidence.
Our CHC solicitors in Leeds can help you prepare for this meeting by reviewing your decision documents, identifying any errors in the assessment, and helping you highlight aspects of your loved one’s needs that may have been overlooked. We can also help you structure your arguments clearly, using language that aligns with NHS criteria.
2. Independent Review Panel (IRP)
If your CHC application is refused, you can request a Local Resolution meeting with your local Integrated Care Board (ICB) [LINK NEW TAB - Find your local integrated care board (ICB) - NHS]. This meeting gives you the opportunity to explain why you disagree with the decision and present additional evidence.
Our CHC solicitors in Leeds can help you prepare for this meeting by reviewing your decision documents, identifying any errors in the assessment, and helping you highlight aspects of your loved one’s needs that may have been overlooked. We can also help you structure your arguments clearly, using language that aligns with NHS criteria.
We Can Advise You When Appealing an NHS Continuing Healthcare Funding Decision
Appealing an NHS Continuing Healthcare decision can be an emotionally draining process, especially when you are already managing your loved one’s care. Our CHC solicitors take on the administrative and evidential burden for you, providing practical legal support and honest advice throughout.
We can:
- Review your CHC decision letter, Checklist, and Decision Support Tool.
- Identify errors or inconsistencies in how your loved one’s needs were assessed.
- Prepare detailed written submissions for Local Resolution or Independent Review Panels.
- Represent you at meetings or reviews to ensure your case is heard fairly.
Our team can also advise on retrospective CHC claims if your loved one paid for care that should have been funded by the NHS.
Why Choose Winston Solicitors?
Our firm has built a strong reputation for professionalism, empathy, and clear communication. As regulated solicitors, we are committed to acting in your best interests at all times and ensuring that your loved one’s rights are protected.
We offer:
- Specialist expertise in NHS Continuing Healthcare funding and appeals.
- A compassionate approach that recognises the emotional challenges families face.
- Transparent advice with clear costs and no hidden fees.
- Local support from our Leeds-based team, assisting clients across England.
With years of experience handling CHC cases, we understand the system and how to present evidence effectively. Our goal is to make the process fairer and less stressful for you and your family.
Contact Our NHS Continuing Healthcare Solicitors
If your NHS Continuing Healthcare funding application has been refused, do not lose hope. Appealing a CHC decision can feel daunting, but you do not have to face it alone.
Contact Winston Solicitors in Leeds for expert legal advice and practical support. We will help you understand your rights, guide you through the appeals process, and work with you to secure the funding your loved one deserves.
Call 0113 320 5000, or leave a message to speak to a specialist CHC expert today.
You normally have six months from the date of the decision letter to request a review. However, in some cases, late appeals may still be accepted if there is a valid reason for the delay. Check your decision letter in case of a shorter timescale being imposed.
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.
Yes. If you believe your relative should have been eligible for NHS Continuing Healthcare, you can request a retrospective review on behalf of their estate. This could result in care fees being refunded if the NHS determines that the person should have been funded.
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.
