My NHS Continuing Healthcare Application Has Been Refused, What Can I Do?

A refusal of NHS Continuing Healthcare can feel like a judgement that the person’s needs are not serious.

That is not what the decision means.

It means the ICB has decided, using the CHC framework, that the person’s assessed needs do not demonstrate a primary health need. You can ask how that conclusion was reached and challenge it if you believe the evidence or process does not support it.

Get the actual decision documents

Do not appeal from a telephone summary.

Ask for the completed Checklist or Decision Support Tool, the multidisciplinary team’s recommendation, the ICB’s written decision and reasons, and information about the review process.

Compare the documents with the care records. Which need do you say was understated, omitted or misunderstood?

Challenge facts before adjectives

“Mum’s needs are obviously complex” is less persuasive than identifying why.

For example: the DST records mobility as predictable, but the falls log shows repeated sudden collapses; the nutrition section says intake is adequate, but records show prolonged prompting and weight loss; the behaviour level omits repeated resistance to essential medication.

Build the challenge around evidence.

What if the ICB disagreed with the MDT?

The National Framework says ICBs should accept multidisciplinary-team recommendations except in exceptional circumstances.

If the MDT recommended eligibility but the ICB decided otherwise, ask for the exceptional reasons and how the decision complies with the Framework.

That is a different issue from simply disagreeing with the level selected in one domain.

What review routes are available?

The person should be given information about local review arrangements.

If the matter cannot be resolved locally, an application may be made for an Independent Review Panel through NHS England in appropriate cases.

The review looks at whether the eligibility decision and process properly applied the National Framework. Follow the timescale stated in the decision correspondence and seek advice promptly if you are unsure.

What happens to care while a dispute continues?

A CHC dispute does not make the person’s care needs disappear.

Clarify who is currently arranging and funding care and whether the local authority, NHS or individual is paying during the dispute.

Keep invoices and records where funding responsibility is contested. Do not stop necessary care simply to strengthen an appeal.

Free independent advice exists

NHS information signposts Beacon for free independent advice about NHS Continuing Healthcare.

That can be useful before paying for representation.

Some cases justify specialist legal advice, particularly where there are substantial historic costs, complex procedural issues or wider legal disputes, but paid representation is not a requirement for every challenge.

Look after the carer during the dispute too

CHC disputes can become consuming.

Families may spend evenings analysing domain wording while still providing the care that triggered the application.

Allocate the administrative work where possible, keep a clear evidence file and set boundaries around how much of each day is given to the dispute. Carers Mind can support the emotional strain independently of the funding challenge.

Last reviewed

5 September 2026

Important informationThis guide provides general information about NHS Continuing Healthcare in England and is not intended to provide legal, financial, medical or other professional advice. Rules and processes differ elsewhere in the UK and individual circumstances can be different. You may wish to check current official information and seek advice from an appropriately qualified professional before making important decisions.