Continuing Healthcare (CHC) appeals process

If you are unhappy with the outcome of a NHS Continuing Healthcare assessment and wish to appeal the decision please find below appeals process.

Patient or their representative should contact the CHC Team.

Email: Broccg.continuingcarereferrals@nhs.net

Telephone: 0203 930 0150

Address: Continuing Healthcare Team, Global House, 10 Station Approach, Hayes, Bromley, BR2 7EH

The purpose of Bromley CCG’s Local Resolution Appeals Process:

  1. To establish that the patient had been comprehensively assessed to allow full consideration in respect of their care needs.
  2. To establish that the procedures used in the original MDT were compliant with those laid down in the National Framework for NHS Continuing Healthcare and NHS Funded Care.
  3. To ensure that the application of the criterion within the National Framework has been properly and consistently applied.
  4. To ensure this is a robust documentation in respect of the decisions made inclusive of the decision making rationale. 

Stage one of the appeals process is to attempt to resolve any concerns initially through an informal two-way meaningful discussion between the CCG representative and the individual and/or their representative. There will be a written summary of this for both parties.  The discussion will be an opportunity for the individual or their representative to receive clarification of anything they have not understood.  The CCG will explain how it has arrived at the decision regarding eligibility, including reference to the completed Decision Support Tool (DST) and primary health need assessment.   Where required this will also be an opportunity for the individual or their representative to provide any further information that had not been considered. 

Following this it may be necessary to proceed to stage two of the Local Resolution Process. 

Stage two involves a formal meeting between the CCG the individual and/or their representative.   In order to facilitate this, the CCG may require additional information, including records and reports.  Once all the information has been gathered by the CCG the meeting will be arranged.  The individual will be able to put forward the reasons why they remain dissatisfied with CCG’s decision. 

The outcome of the formal meeting will be communicated to the individual and/or their representative within 4-6 weeks of the meeting. The individual and/or their representative will receive a full record of the deliberations of the meeting. Clear and evidenced written conclusions on the process followed by the CHC team and also on the individual’s eligibility for NHS Continuing Healthcare, together with appropriate recommendations on actions to be taken. 

In the event you remain dissatisfied, stage three of the appeals process is that you are entitled to submit a request for an independent review to NHS England, which is the organisation responsible for the Independent Review Process to consider your case, this would need to be submitted in writing within 6 months of the outcome of Local Resolution Panel. 

Part of the appeals process is that we will ask that you complete a consent form, doing this will enable the appeals team to request the relevant health and social care records for the appeal.

NHS Bromley CCG, Global House, 10 Station Approach, Bromley, BR2 7EH

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