How to appeal a CHC decision
If your relative has been assessed and found not eligible for NHS Continuing Healthcare, you have the right to request a review. This is one of the most financially significant processes a family can pursue — a successful appeal means all care costs move to the NHS, regardless of savings. The process has defined stages and time limits. This guide takes you through each one.
The first thing to do is request the written outcome of the CHC assessment — the decision letter, the completed Decision Support Tool (DST), and the checklist if one was completed. You are entitled to copies of all of these. Do this in writing by email to the Integrated Care Board (ICB) that carried out the assessment.
The DST is the document that shows how your relative's needs were rated across 12 care domains. Each domain is rated as No Need, Low, Moderate, High, or Severe. Eligibility for CHC typically requires a Primary Health Need — usually indicated by one Severe rating, two High ratings, or a combination of factors across domains. Read the ratings carefully — errors in individual domain ratings are a common basis for successful reviews.
The first formal stage is a local review, requested from the Integrated Care Board (ICB) that made the original decision. You must request this within six months of receiving the written decision. Write to the CHC team at the ICB stating that you are requesting a local review under the NHS Continuing Healthcare review process, and give the specific reasons you believe the decision was incorrect.
At the local review, the ICB must consider any new evidence you submit. Bring medical records, care notes, GP letters, any specialist assessments, and your own documented observations of your relative's needs. A family member or advocate can attend with you. The ICB should complete the local review and give you a written outcome.
If the local review does not change the decision and you still believe it is wrong, you can escalate to an Independent Review Panel (IRP) via NHS England. This must be requested within six months of receiving the local review outcome.
The IRP is independent of the ICB. It considers the evidence and the process followed. It can uphold the original decision, find in your favour, or ask the ICB to reassess. The panel's recommendation is not automatically binding on the ICB, but the ICB must take it seriously and explain any departure from it in writing.
To request an IRP, contact NHS England's CHC Review team. The contact details will be in your local review outcome letter, or can be found via NHS England's website.
If your relative received care in a care home or at home during a period when CHC was never assessed, and you believe they would have qualified, you can apply for a retrospective review. This can potentially recover care fees paid during that period.
Retrospective reviews are complex and require detailed evidence of your relative's care needs during the period in question — medical records, care home records, GP notes. The process is the same in principle as a standard CHC review but the evidence gathering is more demanding because you are reconstructing a picture of needs from a previous period.
How to challenge a financial assessment
If you believe the council's financial assessment has incorrectly counted assets, applied the wrong thresholds, or failed to disregard income or property it should have excluded, you can formally challenge it. This guide covers how to do that, what to check first, and what the formal process looks like.
Before raising a formal challenge, verify what the rules actually say. The most common errors in financial assessments are: including the family home when it should be disregarded (because a spouse, civil partner, or dependent relative still lives there, or because the person is receiving care at home rather than in a care home); incorrectly valuing assets; failing to apply the correct capital thresholds for 2025/26 (£23,250 upper / £14,250 lower); and not disregarding income the rules say should be excluded.
The council must apply the rules set out in the Care and Support Statutory Guidance and the relevant charging circulars. These are public documents. The 2025/26 charging circular is available on GOV.UK and lists every category of capital that must be disregarded.
Write to the council's adult social care financial assessment team. Be specific: state exactly what you believe is wrong, cite the specific rule or disregard that applies, and ask for a written response. This letter creates a formal record and starts the clock on the council's obligation to respond.
Do not telephone. Written communication ensures everything is on record. If you email, follow up to confirm receipt.
Template letter — challenging a financial assessment
Adapt this for your specific situation. Fill in the [bracketed] sections.
Every council must have a formal complaints procedure for adult social care. If the financial assessment team does not resolve the issue to your satisfaction, submit a formal complaint under that procedure. The council must acknowledge your complaint and give a written response within a set timeframe (typically 20 working days for stage one).
If the formal complaint does not resolve the issue, you can escalate to the Local Government and Social Care Ombudsman. The Ombudsman investigates complaints about councils and can recommend the council put things right, including repaying money charged incorrectly. There is no fee to use the Ombudsman. Contact: 0300 061 0614 or lgo.org.uk.
How to make a complaint about a care home
Every care home registered with the CQC is legally required to have a complaints procedure. Using it formally — in writing — creates a record and triggers obligations on the home to respond. This guide covers how to complain effectively, when to escalate beyond the home, and what the CQC's role is.
All complaints to care homes should be in writing. Email is fine — it provides a timestamped record. Address it to the registered manager and state clearly: what happened, when it happened, who was involved, what the impact was on your relative, and what outcome you want. If you have already raised it verbally and nothing has happened, say so and give the date.
Under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, care homes must acknowledge a complaint in writing within three working days and provide a full written response within 28 days. If it will take longer, they must tell you and explain why.
Template — formal complaint to a care home
If the care home does not respond within the required timeframe, or their response is inadequate, you can escalate to the Local Government and Social Care Ombudsman (LGSCO). The Ombudsman investigates complaints about care homes — both council-funded and self-funded placements. There is no fee.
You should normally have exhausted the home's own complaints procedure first. If the home has failed to respond at all, or has responded inadequately, document this clearly when contacting the Ombudsman.
If your complaint involves an immediate safety concern — a risk of serious harm to your relative or other residents — report it directly to the CQC without waiting for the home's complaints process. The CQC does not investigate individual complaints on behalf of families, but it does act on intelligence about safety risks when making inspection decisions. Use their online reporting form at cqc.org.uk or call 03000 616161.
If you believe a crime has been committed — theft, physical abuse, financial abuse — contact the police and the council's adult safeguarding team simultaneously. Do not wait for the home's complaints process to complete before doing this.
How to request a needs assessment
A needs assessment from the council is the starting point for all care support. It is a legal right under the Care Act 2014 — no GP referral is required and no minimum level of need has to be demonstrated to trigger the right to one. This guide tells you exactly how to request one, what happens, and what to do if the council delays or declines.
Contact the adult social care department of the relevant local council — the council for the area where the person currently lives. For most people in this area that is BCP Council (Bournemouth, Christchurch and Poole). You can refer online, by phone, or in writing. Always follow up any phone call with a written confirmation so you have a dated record of when the request was made.
Template — request for a needs assessment
Out of hours: 01202 738256
Online referral: bcpcouncil.gov.uk/adult-social-care
The council cannot decline to carry out a needs assessment if the person appears to have care and support needs. There is no threshold that must be met before the assessment takes place — the threshold applies to whether needs are eligible for council support after the assessment, not to whether the assessment happens at all.
There is no set time limit in the Care Act for how quickly the council must carry out the assessment, but the statutory guidance says it must happen within a reasonable time. What is reasonable depends on urgency. If there is an urgent situation — for example, someone has just been discharged from hospital — this must be treated as a priority.
After the assessment you will receive a written outcome. If eligible needs are found, the council must produce a care and support plan. If the council finds no eligible needs, they must tell you in writing and explain why. Even if needs are found to be below the eligibility threshold, the council must still give you information and advice about what support is available.
If you believe the assessment outcome is wrong — that needs have been underrated or missed — you can request a review of the assessment. Put this request in writing, state specifically which needs you believe were not properly assessed, and provide evidence. If a formal review does not resolve it, the council's complaints procedure and the Local Government Ombudsman are the next steps.