CHC local resolution (appeal)

If you disagree with the eligibility decision made by the CHC Team (after a full assessment of eligibility including the completion of the Decision Support Tool - DST), or if you have concerns about the procedure followed by the CHC Team to reach its eligibility decision, you can ask the CHC Team to reconsider your case through its local resolution process.

To request local resolution please write to the CHC Team and send to cwsccg.chcappeals@nhs.net or post to West Sussex Continuing Healthcare, Wicker House, High Street, Worthing, BN11 1DJ.

On receipt of your request the appeal will be logged and a CHC Practitioner will be allocated to reconsider your case. You will receive an acknowledgement letter and may be asked to provide further information. We aim to review all requests within three months of their receipt, but in some cases it may take longer.

There are three stages of CHC appeal:

  • Stage 1 – informal resolution
  • Stage 2 – formal resolution
  • Stage 3 – NHS England (NHSE) independent review (IR)

Stage 1 – informal resolution

The CHC practitioner will call you to discuss your concerns and ensure they understand how you would like them to focus their review. This call is also an opportunity for you to ask questions and learn more about the process and timeframes. The case (including all assessment documents and evidence) is reviewed by the CHC practitioner and further actions could be identified or the case resolved at this stage.

Stage 2 – formal resolution

If a satisfactory solution cannot be found through informal resolution, then a Local Resolution Meeting (LRM) will be offered to provide all parties with the opportunity to work together in reaching a consensus.

The CHC Team would strongly recommend appellants attend an LRM as it is often a requirement if you wish to seek independent review at a later date.

You will have an opportunity to supply any evidence or information in advance of an LRM and finally a decision would be communicated in writing.

It is important the LRM is used as a forum where all parties can respectfully engage in discussions with the assessment and outcome.

Stage 3 – independent review

Where it has not been possible to resolve the matter through the local resolution process, you can apply to NHSE for an independent review of the decision.

Contact details for NHSE are provided at completion of you local resolution within the final CHC Team decision letter.

Please be aware NHSE can ask the CCG to attempt further local resolution prior to the independent review.

What is a checklist challenge

If following screening for NHS CHC, using a checklist, you disagree with a decision not to proceed to full assessment of eligibility for NHS Continuing Healthcare, you can ask the CHC Team to reconsider the decision. We refer to this as a checklist challenge.

Your request is logged and both the checklist and any supporting information is reviewed to ensure the correct decision has been made. This process is completed as soon as possible and usually within three months.

A final written decision letter is sent on completion of the process and if applicable provides details of the CCG complaints process if you wish to request further consideration.

For further information on local resolution or checklist challenges please contact the CHC Team at cwsccg.chcappeals@nhs.net or call 01903 708 601.

This service is available Monday to Friday 9am – 4.30pm with a response time within 48hrs.