NHS Continuing Healthcare - Challenging a decision

If your client has been through the NHS Continuing Healthcare assessment process and they disagree with the decision, they can challenge it by appealing. 

The CCG should provide information on how your client can appeal the decision and the deadline for their appeal. Your client should confirm the deadline as soon as possible to make sure they have time to appeal. Beacon, an independent information and advice service funded by NHS England has stated that these deadlines can range from two weeks to six months1.

The process normally consists of three stages: 

  • Stage 1 – is the local resolution procedure adopted by the CCG. It varies but it normally involves a meeting potentially followed by a panel review.
  • Stage 2 – is an Independent Review convened by NHS England, which, if accepted, may lead to a formal review of the CCG’s decision. Your client will be invited to attend part of the panel hearing.
  • Stage 3 – is the referral of your client’s case to the Parliamentary and Health Service Ombudsman for a full independent investigation. Depending on this outcome there may be further stages involved.

The appeal process can be time-consuming and complicated and it may be in the person’s interests to seek independent information and advice.

 

Our sources

1Challenging and appealing a decision you don’t agree with, View - Beacon 

Information researched and accurate as of February 2020. Not to be relied upon by advisers or their clients.