How to write an appeal for NHS Continuing Healthcare

How to write an appeal for NHS Continuing Healthcare

How to write an appeal for NHS Continuing Healthcare What to include in an NHS Continuing Healthcare appeal

Tip no. 23 in our series of 27 top tips on NHS Continuing Healthcare

If you’ve been told your relative is not eligible for NHS Continuing Healthcare, you may be wondering what to do next.

The NHS Continuing Healthcare team at the CCG should have provided you with the funding decision in writing. In addition they should have given you a copy of the assessment notes (e.g. the Checklist and/or the Decision Support Tool).

You should also be given information how to appeal.

If you’ve been turned down at the full assessment stage, after a multidisciplinary team meeting, the CCG should give you a written rational for the funding decision. Your next task is to decide whether to appeal.

If you do decide to appeal, you need to pull together various types of information. You may already have done much of this for the full assessment meeting.

If you weren’t able to prepare properly for the full assessment, read more here about that here – it will help you with the appeal.

Here’s what to include when you write an appeal for NHS Continuing Healthcare

Essentially it will be a document that pulls together all the reasons why you believe the funding decision is wrong:

  • Highlight everything in the assessment notes that is incorrect, misleading or missing.
  • Pull together information about your relative’s care needs in every care domain, and suggest the correct scores. (A care domain is an ‘aspect’ of care, e.g. Mobiity, Behaviour, etc., and these are set out in the Checklist document and the Decision Support Tool.)
  • Check the care notes that are kept by the care provider. Do they let your relative down? It’s not unusual for care notes to be incomplete, inaccurate and lacking in detail. If this is the case, say so in your appeal and also take it up with the care provider; a failure to keep proper notes can put your relative at risk.
  • Highlight any actions or statements on the part of assessors that have been unacceptable, intimidating, unprofessional or that shows ignorance of how the assessment process is supposed to work.
  • And finally, pull together anything else that supports your case that has not been properly considered.

Once you’ve done all of that, send it to the NHS Continuing Healthcare team at the CCG. You may need to chase them regularly about your appeal. In all your dealings with them,be prepared to stand your ground.

Tip no. 22: What to say when denied NHS Continuing Healthcare

Tip no. 24: What is a joint package of care?

You don’t have to fight this battle alone

Fighting a Continuing Healthcare funding battle alone can feel daunting. If you need to talk to someone about your case, read more here.

1 Comment

  1. Kerry buckley 2 weeks ago

    If I could give any advice it’s please take up the advice!
    I am now in my 7th year appealing retrospectively against my fathers care home fees. He was never given an assessment only a financial assessment. The authorities have NO records from social care or any of the care homes my dad stayed in. If it were our family who had no reports or assessments our case would have been thrown out at the first hurdle but they have ignored the fact that all records have been illeagally disposed of! We have deadlines to ensure our appeal is placed but they ignore any deadlines they may have and I have had to constantly chase them for information. I am now waiting for an independent appeal (2 months) not expecting anything different so will be going to parliament, they want you to give up but my goodness just makes me want to go on even more. 😔😔

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