Urgent help: In an emergency call 999. For urgent medical help call NHS 111 or go to 111.nhs.uk. Otherwise, contact your GP. In a mental health crisis, call 111 and choose the mental health option.

CHC evidence and appeals: how to challenge a decision

In short: You can challenge a CHC decision. Good evidence about day-to-day needs matters most.
A friendly drawing of a letter and a pen.

In short

  1. Good evidence is the key. Keep a daily diary.
  2. Ask for copies of care records and the DST.
  3. To challenge, ask your ICB for a review as soon as you can. Your decision letter should say the time limit.
  4. Next, NHS England independent review. Then the Ombudsman.
  5. You may be able to claim back past care costs.

NHS Continuing Healthcare guide: Start here · Checklist, assessment and the 12 areas · Evidence and appeals · Should I pay a firm? · Free printable checklist

You can do all of this yourself, for free. You do not need a solicitor or a paid firm to ask for an assessment, send evidence or appeal. Free help: Beacon (free CHC advice line 0345 548 0300, named on the NHS website) and Age UK Advice Line (free, 0800 678 1602).

Preparing evidence

How to challenge a decision (England)

  1. Local resolution. Write to your ICB to ask for a review. Do this as soon as you can. Each ICB must publish its own process with timescales, and your decision letter should explain them. Older Department of Health guidance (2012) says to ask no later than 6 months after the decision, and that the ICB should decide within 3 months. Do not wait: if you are near or past 6 months, ask anyway. Say which areas you think are wrong and why. Source: Department of Health: time limits guidance and the National Framework.
  2. Independent review by NHS England. If you are still unhappy, ask NHS England for an independent review. Use the contact details in the ICB's local resolution letter. Older Department of Health guidance (2012) says to ask within 6 months of that letter. NHS England says you then have 6 weeks to return its form, and it usually takes 3 to 6 months. See NHS England: independent review process.
  3. Health Service Ombudsman. If you are still unhappy after the independent review, you can complain to the Parliamentary and Health Service Ombudsman. You should usually complain within 12 months of knowing about the problem.

If you missed a time limit for a good reason, ask anyway. The rules allow some late requests.

Claiming back past care costs

If someone should have been assessed for CHC but was not, and paid for care, you can ask about a previously unassessed period of care. This is usually only for care after 1 April 2012. You can ask for someone who has died, if you are the executor or have a right to claim. Each ICB sets its own timescale. Good practice is about 6 months from a complete application if the period is a year or less, and no more than 12 months for longer periods, except in exceptional cases. See GOV.UK: previously unassessed periods of care.

← Back to NHS care (CHC)

Information only. This page explains official guidance in plain English. It is not legal or medical advice. Rules can change. For advice about your own case, contact Citizens Advice or another free adviser.

Where this applies: England. Scotland, Wales and Northern Ireland have different rules.

Written by Social Care Made Easy. Last checked: 25 October 2026.