Can I appeal on behalf of a relative who has passed away?

Yes. The executor or administrator of the estate can pursue an appeal. If the appeal succeeds, the NHS must refund any care fees the family paid during the period CHC should have been in place. The refund forms part of the estate.

What is a Local Resolution meeting?

A Local Resolution meeting is the first formal stage of appeal. The Integrated Care Board will review the Decision Support Tool with you, hear new evidence, and decide whether to overturn the original decision. You can attend with a family member, advocate, or solicitor.

What is an Independent Review Panel?

If Local Resolution fails, NHS England convenes an Independent Review Panel — an impartial panel that reviews whether the original assessment was carried out correctly. The panel can recommend that CHC funding be granted. Many initial refusals are overturned at this stage.

What evidence do I need to support a CHC appeal?

Strong appeals rely on the original Decision Support Tool, the multidisciplinary team minutes, GP records, hospital letters, care home daily records, behaviour and continence charts, and contemporaneous family notes. A specialist solicitor can request these on your behalf.

How long does a CHC appeal take?

Local Resolution typically takes three to six months. If escalated to an Independent Review Panel, the full process can take a further nine to eighteen months. Retrospective claims for past care can take longer because records have to be located and reviewed.

What happens if the Independent Review Panel also refuses the appeal?

You can complain to the Parliamentary and Health Service Ombudsman, which can investigate procedural failures. As a last resort, judicial review in the High Court is possible for cases involving significant sums or clear procedural errors. A specialist solicitor will advise on whether either route is realistic.

NHS CHC appeal — how to challenge a refused Continuing Healthcare decision

If your relative has been refused NHS Continuing Healthcare, you have the right to appeal that decision. Many refusals are successfully overturned on appeal — often because the original assessment was conducted incorrectly, key health needs were underscored, or the family was not properly involved in the process.

Last reviewed: 1 March 2025·Reviewed by: CareGuide UK Editorial Team, reviewed by an SRA-regulated CHC solicitor

Why CHC applications are refused

Common reasons applications fail include health needs scored incorrectly on the Decision Support Tool, cognitive and behavioural needs being underweighted, the family not being given proper opportunity to contribute, the assessment being conducted when the person was temporarily stable rather than at their typical level of need, and fast-track criteria not being considered for rapidly deteriorating conditions. These failings are not unusual — and they are exactly the grounds on which most successful appeals are won.

Your right to appeal — the formal process

Step 1 — Local Resolution. Request a Local Resolution meeting with the Integrated Care Board within six months of the decision.
Step 2 — Independent Review Panel. If Local Resolution fails, request an Independent Review Panel hearing through NHS England.
Step 3 — Parliamentary and Health Service Ombudsman. If still refused, escalate to the Ombudsman for an investigation into procedural failures.
Step 4 — Judicial review. A last resort for cases involving significant sums or clear procedural failures, brought in the High Court.

What to do immediately after a refusal

Request the full Decision Support Tool document in writing
Request the minutes of the multidisciplinary team meeting
Note the date of the decision — the six-month Local Resolution window starts here
Begin gathering medical records, care notes, and GP letters documenting health needs
Do not accept the verbal explanation — get everything in writing

The most common grounds for a successful appeal

The DST was completed incorrectly or key domains were underscored
The assessment was not carried out by a properly constituted multidisciplinary team
The family was not given adequate opportunity to contribute evidence
The person was assessed during a period of temporary improvement
Fast-track criteria were not considered despite a rapidly deteriorating condition
The decision letter does not adequately explain the reasoning

Retrospective appeals — claiming back fees already paid

If the appeal succeeds, the NHS must refund care fees paid during the period when CHC should have been in place. This can cover periods going back years and amounts to significant sums. Read our full guide to care fee reclaim →

How a specialist solicitor can help

No-win-no-fee CHC appeal solicitors review the Decision Support Tool, identify procedural and scoring errors, prepare written submissions, and represent families at Local Resolution and Independent Review Panel hearings. Specialist representation significantly increases the chances of a successful outcome — and because most firms work on a no-win-no-fee basis, you only pay if the appeal succeeds.

Frequently asked questions

You have six months from the date of the decision to request a Local Resolution meeting with the Integrated Care Board. If that fails, you have a further six months from the local decision to escalate to NHS England's Independent Review Panel. Acting quickly preserves your options — these deadlines are firm.