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.

5 Comments

  1. Michael Riggs 2 weeks ago

    My local CCG ( clinical commissioning group) assessed my terminally ill wife in April and decided she was not eligible for continuing healthcare or Fast Track funding despite the supporting evidence of her consultant neurologist and GP. My request that she be assessed by the Coughlan Test has been ignored though I had sent evidence of her meeting and exceeding the Test’s criteria. My wife died in October, so survived 6 months following the assessment.
    Now I am appealing against the CCG’s decision. The CCG want a copy of her will . When I asked why , they said that their procedures require me to establish my identity and eligibility to receive money that might be paid into my late wife’s estate. The CCG has not offered any information about the state of my appeal, either to reject or accept it. Why is the Will relevant? Some kind of hidden means test? And what happens about Coughlan now that my wife is dead ?

    • Care to be Different 2 weeks ago

      Hi Michael. Sorry to hear this. Requesting the Will is the only way that the CCG can ensure that you are the person who has legal authority to handle you late wife’s affairs – it has nothing to do with what’s in the estate. Hope that helps but contact us if you would like help with the Appeal. Kind regards enquiries@caretobedifferent.co.uk

  2. Keith 5 months ago

    Does anybody have the phone number for the solicitor that was posted on here thanks

  3. Jane Doe 6 months ago

    I’m in the middle of dealing with this for my father at the moment, and it occurs to me that an assessor who wilfully disregards the law and legal precedents in pursuit of getting a lower result may well be guilty of misconduct in a public office which carries a prison sentence in fact up to a life sentence. Has this avenue ever been explored?

  4. Kerry buckley 7 months 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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