CHC, put simply.
Disagree with a CHC decision?
You are not alone.
If you believe the assessment did not properly reflect the person's needs, you can ask for the decision to be reviewed.
A CHC decision is not always the end of the journey.
Recent NHS data shows
In Quarter 1 of 2025/26, only around 17% of people assessed for CHC were found eligible.
This is down from around 31% in 2017/18.
Many families who challenge decisions are successful on appeal.
Published data suggests around 22% of appeals at local NHS level are successful, with further decisions overturned at Independent Review stage.¹
Only around 17 in every 100 people assessed were found eligible
in recent NHS statistics. This is why understanding the process matters.
Why do families appeal?
Common reasons include:
Important evidence was not considered
Needs were underestimated
Risks were minimised
The DST focused on scores rather than the whole picture
The four key characteristics were not properly analysed
The rationale for the decision was unclear
The CHC appeals process
Three stages — each with a distinct purpose.
Step 1
Local Resolution
You ask your Integrated Care Board (ICB) to review the decision.
The ICB should reconsider:
- The evidence
- The DST
- The rationale
- The application of the National Framework
Step 2
Independent Review Panel (IRP)
If you remain dissatisfied, you may request an Independent Review.
The panel usually consists of:
- An independent chair
- A health representative from another area
- A Local Authority representative from another area
The purpose is to review:
Was the National Framework followed? Was the evidence considered properly? Was the eligibility decision sound?
Step 3
Parliamentary and Health Service Ombudsman
If concerns remain, you may complain to the Ombudsman.
The Ombudsman investigates:
- Maladministration
- Procedural failings
- Poor communication
- Failures to follow national guidance
What makes a strong appeal?
A strong appeal is rarely:
"I disagree."
It is usually:
"The evidence does not support the conclusion."
Strong appeals often focus on:
- The totality of need
- Nature, Intensity, Complexity, Unpredictability
- The rationale for the decision
- Evidence of risk
- Whether needs were underestimated
Some common misunderstandings
These do not automatically prevent eligibility.
"I don't have two Severe scores."
This does not automatically prevent eligibility.
"I don't have a Priority."
This does not automatically prevent eligibility.
"My relative has dementia."
Diagnosis alone does not determine eligibility.
The key question remains:
Does the person have a Primary Health Need?
An appeal is not asking for special treatment.
It is asking:
Was the National Framework applied correctly?
Was the evidence considered fairly?
Was the decision supported by the person's actual needs?
Why CHC Clarity exists
Many families tell us:
"We just wanted someone to explain it."
To explain NHS Continuing Healthcare clearly.
Calmly.
And in plain English.
CHC Clarity · CHC, put simply.
¹ Statistics are indicative and based on published NHS data. Figures may vary by region and period.