Appealing a NHS Continuing Healthcare Decision
How do I Appeal?
If you or your relative has had a NHS Continuing Healthcare (CHC) assessment and
you do not agree with the eligibility outcome you have the right to appeal.
Throughout the process we advocate your full involvement within this and would
expect that you would have had any decision making fully explained to you.
However, if you wish to appeal the decision, please contact the Continuing
Healthcare team at the address detailed on the decision letter. They will send you
an appeal form (this is also available on the Trust website) and support you through
the process. You will need to submit your appeal reasons within six months of
receiving the Trust’s written decision letter.
What will happen next?
The first stage is for the Lead Nurse to review your case and check that the process
has been followed correctly and, where possible, to seek local resolution. This may
involve either a meeting or a telephone discussion between the client/family/legal
representative and Lead Nurse/Local Liaison and Resolution Officer. At this meeting
we will endeavour to explain our process, answer any questions and document any
additional information that you provide us with.
If it is agreed that a further assessment of your needs is required, your
representative will be invited to attend to ensure that you are both fully involved in
the process. We aim to complete stage 1 within 28 working days, although it may
take a little longer if a further assessment is required.
Once stage one has been completed, if you remain dissatisfied with the outcome
then you have the right to proceed to stage two of the appeals process (Local
Review Panel). This panel will consist of a multidisciplinary team who have had no
previous involvement in the Continuing Healthcare decision making process. You
will be invited to attend the panel to explain why you wish to appeal the eligibility
decision. We aim to send the decision letter and completed Decision Support Tool
to you within twenty eight days of the panel date.
We hope that upon completion of these two stages that you will be satisfied with the
decision making. However, if this is not the case you will have the right of appeal to
NHS England. Full contact details will be provided with our decision letter.
Appealing on behalf of a family member or friend
You can appeal on behalf of a friend or relative, but in every case, whether someone
is acting on behalf of a relative or friend, we will need to see evidence that you are
the patient’s legal representative which can be in the form of written consent from the
client or a relevant power of attorney.
The appeals form includes a consent to share information authority which enables us
to request documentation from organisations such as care homes and GP surgeries
to support an appeal.
Page 1
Where can I find further information?
The multidisciplinary team will use the Department of Health National Framework for
NHS-funded Continuing Healthcare 2012 and Decision Support Tool to inform their
decision making of the client level of needs. These documents can be found on the
Department of Health’s website at www.gov.uk/government
Advocacy and Support
If you require assistance or advice relating to the process, the following
organisations can offer support:



Healthwatch - www.healthwatch-uk.org
Age UK - www.ageuk.org.uk
SEAP - www.seap.org.uk can provide you with support if you wish to make a
complaint regarding the Continuing Healthcare process
Where to find further Information
If you have any questions, please contact the Continuing Healthcare team at the
following address for Torbay enquiries:
Cavanna House
Riviera Park
Nicholson Road
Torquay
TQ2 7TD
Email: chcteam.tct@nhs.net
Tel: 01803 210738
For any enquiries for Southern Devon areas please contact:
Albany Clinic
Albany Street
Newton Abbot
TQ12 2TX
Tel: 01626 358650
Email: chc.southernteam@nhs.net
For further information on NHS Continuing Healthcare visit our website at
www.tsdhc.nhs.uk
Page 2