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Challenging an NHS Continuing Healthcare decision
How do you appeal an NHS Continuing Healthcare decision?
If an Integrated Care Board decides that a person is not eligible for NHS Continuing Healthcare after a full assessment, the decision can be challenged through the ICB’s local resolution process. If it remains unresolved, the individual or representative may ask NHS England for an independent review.
Reviewed by Paris Theodorou, Solicitor & Principal · Theodorous · SRA 809508 · Updated 26 September 2026
What is the CHC appeal process?
Get the decision and assessment documents
Obtain the written decision, the completed Decision Support Tool, the multidisciplinary recommendation and any reasons for departure from it.
Identify the actual errors
Compare the reasoning with the contemporaneous care evidence. The strongest grounds usually identify specific omissions, under-scoring, misunderstood evidence or failures to consider how needs interact.
Use local resolution
The first formal challenge is normally the ICB’s local resolution process, where the decision and supporting evidence are reconsidered.
Request independent review if unresolved
If local resolution does not settle the dispute, the person or representative may ask NHS England to consider an Independent Review Panel.
Is there a six-month deadline?
Many ICBs publish a six-month time limit for requesting review of a CHC eligibility decision. That should not be presented as a single universal statutory rule. Check the decision letter and the relevant ICB procedure promptly, because local wording and exceptional-circumstances provisions can differ.
What should a strong CHC appeal contain?
A useful appeal connects the evidence to the National Framework. It is not simply a complaint that the result feels unfair.
Specific domain challenges. Identify where the recorded level does not match the evidence.
Primary health need analysis. Explain how nature, intensity, complexity and unpredictability apply to the totality of needs.
Interactions between needs. Show where several moderate-looking issues combine to create a materially more demanding care picture.
Well-managed needs. Explain the care, supervision, medication or equipment that is preventing incidents rather than treating the absence of incidents as absence of need.
Contemporaneous evidence. Cross-reference care plans, daily records, incidents, medication, risk assessments and professional entries.
For the underlying test, see the primary health need guide. For successful care masking the underlying need, see well-managed needs.
Does the DST decide eligibility automatically?
No. The DST supports evidence-based recommendation and decision-making, but the final analysis remains whether the person has a primary health need. Domain levels are important evidence, not a substitute for the overall judgement.
What if records are missing?
Identify the missing categories, explain why they matter and ask whether they are reasonably obtainable. An appeal should not casually proceed on an obviously incomplete evidential picture. At the same time, avoid inventing universal records-production deadlines that do not apply to every provider or process.
Can you appeal without a solicitor?
Yes. Families can use the ICB process themselves. Specialist legal help may add value where the records are extensive, the reasoning is technically complex, the case is moving to independent review or the family wants the evidential analysis and submissions handled for them.
Build the appeal in the right order