CHC appeal help in England
If the NHS has refused or ended your relative's NHS Continuing Healthcare (CHC) funding, we can take the CHC appeal through each stage for you.
Can you appeal a CHC decision?
If the NHS has refused CHC funding, you can appeal. In England there are three stages: local resolution with the integrated care board (ICB), an Independent Review Panel run by NHS England, then the Ombudsman. We can run the appeal for you from £2,995.
You can challenge a decision that the person isn't eligible for CHC. That includes a decision at a review to end funding they already have. The National Framework, the written rules for CHC in England, says the same disputes procedure applies to both (pages 62 to 63). The ICB is the NHS body that decides CHC funding in your area. Its decision letter should explain how to ask for a review and the timescales for doing so (page 67).
A negative Checklist works differently. The Checklist is the short screening form that shows whether a full assessment is needed. If it comes back negative, the first step is to ask the ICB to reconsider (Checklist guidance, "What happens following a negative checklist"). Our CHC Checklist guide explains how to ask.
CHC Funding Support helps families in England with each stage of a continuing healthcare appeal. If the full assessment hasn't happened yet, our CHC assessment support helps you prepare for it instead. We are not part of the NHS.
What are the stages of a CHC appeal?
A CHC funding appeal normally runs through three stages in order, from the ICB to NHS England and then to the Ombudsman.
Local resolution
You ask the ICB to look again at its decision, using its own published process. That usually means a letter setting out where the assessment went wrong, and often a meeting with the ICB.
Independent Review Panel
If local resolution doesn't settle it, you can apply to NHS England for an independent review. The panel looks at whether the person has a primary health need. That means the main part of their care is focused on health needs.
The Ombudsman
If the panel upholds the decision and you still disagree, you have the right to complain to the Parliamentary and Health Service Ombudsman.
| Stage | Who runs it | Time limit | What you send | How long it takes | Source |
|---|---|---|---|---|---|
| Local resolution | Your integrated care board | No national limit. Each ICB sets its own, so check the decision letter | A written request saying why the decision is wrong, with the evidence | No national timescale. ICBs "should deal with requests for review in a timely manner" | National Framework, page 67 |
| Independent Review Panel | NHS England | Return the application form within six weeks. The guide doesn't say when the six weeks start | The application form, which is your final chance to add information | Typically "takes three-to-six months" | Independent Review guide, pages 3 to 5 |
| Ombudsman | Parliamentary and Health Service Ombudsman | Within a year of first knowing about the matter, unless the Ombudsman accepts a later complaint | A complaint in writing, once the panel has upheld the decision | Not stated in the National Framework | National Framework, page 70. Health Service Commissioners Act 1993, section 9 |
NHS England can also send a case back to the ICB for more local resolution. Or it can take a case straight to review where local processes "would cause undue delay" (National Framework, page 68).
What are the CHC appeal time limits?
There's no national deadline for asking for local resolution. The National Framework leaves it to each ICB to publish a process that is "fair, transparent, includes timescales" (page 67). So look first at the decision letter, then at the ICB's own policy. Limits vary from one ICB to the next. NHS Gloucestershire, for example, asks for a review request "within six months from the date of your decision letter". That's from its continuing healthcare page, read 13 November 2026. If you can't find a limit, ask the ICB in writing and act early.
The Health Service Commissioners Act 1993 sets the time limit for the Ombudsman. A complaint should be made within a year of the day the person first knew about the matters in it. The Ombudsman can accept a later complaint if it considers that reasonable (section 9(4)). The complaint must be in writing (section 9(2)). We haven't confirmed how the Ombudsman counts the year after local resolution and an Independent Review. So check the Parliamentary and Health Service Ombudsman's website before you rely on any date.
Return the Independent Review form within six weeks
NHS England's guide says you'll need to return the application form within six weeks, and it doesn't say when the six weeks start. Check the form you're sent for a date, and treat that date as firm (Independent Review guide, page 3).
How successful are CHC appeals?
NHS England publishes how many local resolution requests each ICB completes, and how many end with the person found eligible. In the 12 months to September 2026, ICBs in England completed 2,786 local resolution requests. Of those, 406, or 14.6%, led to eligibility (NHS England CHC and FNC data, Q2 2026/27, published 12 November 2026, our sums).
The rate moves from quarter to quarter. In July to September 2026 alone, 100 of 634 completed requests led to eligibility, which is 15.8%.
We haven't found national figures for Independent Review Panel outcomes, so we can't give you a success rate for that stage. These numbers describe the whole of England. They can't predict how one appeal will go, since every appeal turns on the person's needs and the evidence.
How to win a CHC appeal
An appeal is stronger when it rests on the National Framework's own words and on records the ICB can check. Several points below refer to the Decision Support Tool (DST). That's the form where the assessment team records a level of need in each of 12 care domains.
- Well-managed needs. The Framework says "well-managed needs are still needs" (National Framework, page 51). If a care domain was scored low because carers keep a need under control, quote that rule and show what the care involves.
- The four characteristics. Nature, intensity, complexity and unpredictability can each show a primary health need, "alone or in combination" (page 24). Describe the person's real days in those terms. Our guide to the CHC eligibility criteria explains each one.
- Evidence from the care notes. Dated records count for more than general statements. Ask for the completed DST, the team's recommendation and the care records it relied on. Then point to the entries that show the need.
- Scoring errors. Go through the DST one care domain at a time. Where the written description of a higher level matches the person, say which level the evidence supports and why.
- A recommendation that was overruled. Sometimes the assessment team recommends eligibility and the ICB decides otherwise. The Framework says that should only happen "in exceptional circumstances, and for clearly articulated reasons" (page 54). Ask for those reasons in writing.
- Procedure. An Independent Review Panel looks at the procedure the ICB followed, as well as the decision itself (Annex D, paragraph 2). So steps that were missed matter.
Put everything into the Independent Review application. NHS England calls the form "your final opportunity to provide further information" (Independent Review guide, page 4). You can't add more at a later stage.
How we help with CHC appeals
We can run a continuing healthcare appeal for you from start to finish, or help at the stage you've reached.
Before you appeal
We start with a case review. We read the decision letter, the DST and the care records to see whether an appeal looks worth making.
Local resolution
We ask for the records and write the local resolution request one care domain at a time. Then we support you at the meeting with the ICB.
Independent Review Panel
If the ICB doesn't change its decision, we prepare the application to NHS England with all the evidence. We also support you at the panel.
The price covers the first stage, when the ICB looks at its own decision again (local resolution). If the case needs to go further, to NHS England's Independent Review Panel or the Ombudsman, we'll give you a written quote for that stage first.
What it costs
Appeal support costs from £2,995.
Appeal support
from £2,995agreed after a case review
Pay half when each stage starts and half after its meeting.
- The decision papers and care records requested for you
- A written local resolution request, one care domain at a time
- Support at the local resolution meeting
- The Independent Review application, if needed, by a separate quote
The price depends on how far the appeal goes and how much evidence there is, so we set it after a case review. The case review costs £495, and we take its fee off the appeal. Our CHC case review page explains what we read and what you get. Every price is on our prices page.
How our price compares
Here's our starting price next to Beacon's published appeal fees.
| Service | CHC Funding Support | Beacon CHC | Compass CHC |
|---|---|---|---|
| Appeals | from £2,995 for local resolution | £276 an hour. Beacon estimates 60 to 70 hours for a whole appeal | No prices published |
Beacon: published prices from its fees page at beaconchc.co.uk, read 12 November 2026, with VAT at 20% added because Beacon adds VAT to its fees. Compass publishes no prices. Where we show a Compass figure, it's what some reviewers on Trustpilot say they paid (review 1, review 2, read 12 November 2026). A quote from Compass may be different.
The work included differs. Beacon charges by the hour, and its estimate is for "the average continuing healthcare case through the appeal process" (Beacon website, read 12 November 2026). Ours covers local resolution, the first stage. We run a competing service, so please check each provider's own website before you choose.
Who pays for care during an appeal?
While you appeal, the decision stays in force, so the current arrangement carries on. The Framework says "the eligibility decision that has been made is effective while the independent review is awaited" (Annex D, paragraph 12). It also says no one should be left without appropriate support in the meantime. In practice, the family or the council keeps paying for care.
If the decision is later changed, the money is dealt with under the Framework's refund rules. Where the council paid, the ICB should refund the council from the date of the original decision. The council should then refund your relative's contributions with interest. Where the family paid privately, the ICB should make an ex-gratia payment directly to them (Annex E, paragraphs 16 to 18). Disagreements about these payments go through the NHS complaints process (Annex E, paragraph 20).
If your relative paid for care in the past and was never assessed for CHC, you may have a separate claim. Our page on reclaiming care home fees explains it.
What we'll tell you in writing
Some decisions are right, and an appeal takes time and money. Before you pay for an appeal, the case review gives you our written opinion on whether one looks worth making. If it does, you'll get a written quote with the full total for each stage before any work starts. If the records don't support an appeal, we'll tell you in writing before you pay for the next stage.
We'll also point you to other help that might suit. That could be council funding or NHS-funded Nursing Care (FNC), a fixed weekly NHS payment towards nursing costs in a care home with nursing.
Our limits
We're a small team, so we keep each case with the same people from start to finish. We work in England only, because the National Framework doesn't apply in Scotland, Wales or Northern Ireland. There's no clinician on our staff. If an appeal needs a clinical opinion, we'll buy one in and agree the cost with you first. We're not solicitors either, and if a case needs legal advice, we'll tell you.
CHC appeal questions
How long does it take to appeal a CHC decision?
It depends on the stage. Local resolution has no national timescale, because each ICB publishes its own. The Framework does say ICBs should deal with requests in a timely manner. NHS England says an Independent Review typically takes three to six months. A complaint to the Ombudsman should normally be made within a year of first knowing about the matter. Ask your ICB in writing for its local timescale.
Can CHC funding be stopped?
Yes. At a review, the ICB can decide that the person no longer has a primary health need. However, the Framework says funding shouldn't be withdrawn without a joint reassessment, and other funding must be agreed and in place first. Reviewers also shouldn't mistake well-managed needs for reduced needs. If you disagree with a decision to stop funding, you can challenge it through the same disputes procedure.
What is the complaint procedure for NHS England?
For a CHC eligibility decision, you apply to NHS England for an Independent Review once local resolution has finished. The ICB's local resolution decision letter gives the contact details to ask for the application form. Issues the panel can't look at, such as the type or location of a care package, go through the NHS complaints procedure. After the panel, you can complain to the Parliamentary and Health Service Ombudsman.
Do I need a solicitor for a CHC appeal?
Not usually. The National Framework says it isn't necessary for anyone to be legally represented at an Independent Review Panel hearing. The person can be represented by family, advocates or advice services if they wish.
What happens if my relative dies during the appeal?
Tell the ICB in writing, or NHS England if the case is with them. The Framework's appeal sections don't cover this directly. Its guidance does cover a person who dies while waiting for an eligibility decision, if they had care that CHC could have paid for. In that case the decision should still be completed, with any payment made under its refund rules. Anyone asking for the records after a death needs proper authority, such as being the executor.
Can you appeal a negative Checklist?
Not to an Independent Review Panel. The panel can't look at an ICB's refusal to carry out a full assessment after a negative Checklist. You can ask the ICB to reconsider. It should give the request due consideration, although it doesn't have to complete a new Checklist. If that doesn't resolve it, the NHS complaints procedure is the route.
This is information, not legal advice. It explains the rules for England, which are set out in the National Framework for NHS Continuing Healthcare.
Sources
- National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, Department of Health and Social Care, July 2022 revision, corrected July 2023.
- NHS Continuing Healthcare: independent review process, public information guide, NHS England, version 3, 3 July 2023.
- NHS Continuing Healthcare Checklist and its guidance, Department of Health and Social Care, 20 October 2026.
- Health Service Commissioners Act 1993, section 9, legislation.gov.uk, as in force on 13 November 2026.
- NHS Continuing Healthcare and NHS-funded Nursing Care data, Q2 2026/27, NHS England, published 12 November 2026.
- Continuing healthcare: review of the decision, NHS Gloucestershire, read 13 November 2026.
Get help with your case
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