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Delays in the Continuing Healthcare (CHC) Appeal Process: NHS North East and North Cumbria Integrated Care Board

Have you gone through the Continuing Healthcare (CHC) process, had a Decision Support Tool (DST) assessment, and made an appeal that is still outstanding? If so, you might have recently received a letter or email from your local Continuing Healthcare lead regarding your CHC appeal.


The suggestion may read ‘the most appropriate way forward, which would be most beneficial to your relative, would be for a current  assessment of her needs to be completed via a new checklist and DST (if the criteria for DST is met) with the caveat that if your relative meets the criteria now, we will look back to see from what date CHC criteria was met.


I recommend that you do not agree to this. Here’s why:


  1. Focus on the Relevant Period: Your appeal is based on a specific period. It is crucial that the needs during that time are accurately assessed, and the focus remains on the relevant period. Everyone’s needs change over time, and a current assessment may not reflect the situation during the period in question.

  2. Backlog of Appeals: The Integrated Care Board (ICB) has a backlog of appeals and needs to report data to NHS England. This suggestion might be a way for the organization to quickly clear their backlog of outstanding appeals and improve the data they give to NHS England.


Appeals ideally should be completed within 3 months and it is not uncommon for more complex cases to take years. Within ‘NHS North East and North Cumbria Integrated Care Board’ In one case, I am aware of a delay of nearly two years, which has been attributed to several factors, the most recent being an organizational restructure.  It is also evident that valuable evidence has gone astray during this period, which is unfortunately not uncommon.


If you feel that your concerns are not being addressed, you may need to escalate the issue through the NHS complaints procedure

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