Continuing Care: Appeals
The question
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the effectiveness of current (a) review and (b) appeal mechanisms for Continuing Healthcare decisions.
Answered by Stephen Kinnock
Integrated care boards (ICBs) are responsible and accountable for NHS Continuing Healthcare (CHC) within their local area. Statutory guidance sets out that all arrangements should place the individual at the centre of the assessment and care-planning process. It also sets out how individuals can request a review on an eligibility decision. This includes setting out that if an individual disagrees with the outcome of a CHC assessment, they may apply to the ICB for a Local Resolution procedure. Where it has not been possible to resolve the matter through this procedure, the individual may apply to NHS England for an Independent Review of the decision. If the original decision is upheld and there is still a challenge, the individual can make a complaint to the Parliamentary and Health Service Ombudsman.
NHS England routinely publishes data on Local Resolution requests as part of their quarterly statistics which include CHC referral and eligibility rates, and which are available at the following link:
https://www.england.nhs.uk/statistics/statistical-work-areas/nhs-chc-fnc/
NHS England has also commissioned a free information and advice service for CHC which individuals and their families might find helpful if they are considering challenging a CHC eligibility decision.
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