NHS CHC Reconsideration Request Letter: Free Template and What to Include

If you need to request reconsideration of a refused NHS Continuing Healthcare assessment, a written letter is the recommended first step — it creates a clear record and shows you're pursuing the matter formally. Below is what a strong nhs chc reconsideration request should include.

What this letter needs to cover

• State the person meets the NHS CHC criteria based on their health needs
• Challenge the specific areas of the assessment that were scored incorrectly
• Request a review by the ICB and an independent review panel if the decision is upheld
• Reference the NHS CHC Framework

Why NHS Continuing Healthcare decisions are so often challenged

NHS Continuing Healthcare provides fully funded care for people with significant, ongoing health needs — and it's one of the most commonly disputed areas in health and social care, since the assessment criteria can be applied inconsistently and the financial stakes (fully funded NHS care versus means-tested local authority care) are substantial.

What to include before you send it

• Reference to the specific assessment and decision you're challenging
• Why you believe the assessed needs meet the threshold for NHS Continuing Healthcare
• Any additional evidence — medical records, care notes, or specialist input not properly considered
• A request for the decision to be reconsidered through the formal review process

Understanding the "primary health need" test

Eligibility hinges on whether someone has a "primary health need" — assessed across several domains including complexity, intensity, and unpredictability of needs — rather than simply having health conditions alongside social care needs. Successful challenges often focus on demonstrating this threshold was met but not properly recognised in the original assessment.

Frequently Asked Questions

Is there a time limit for requesting a reconsideration?
Yes — you generally need to ask the ICB for a review within 6 months of the date of the decision letter, so it's worth acting promptly.

What if the local reconsideration doesn't change the outcome?
You can apply to NHS England for an independent review, and if you are still unhappy after that, complain to the Parliamentary and Health Service Ombudsman.

[Your Name]
[Your Address]
[Your Postcode]
[Your Phone Number]
[Your Email Address]
[NHS Continuing Healthcare Team]
[Name of Integrated Care Board]
[Address]
[Postcode]
[Date]

Dear [Name / Continuing Healthcare Manager],

Subject: Request for review of NHS Continuing Healthcare decision – [Patient Name], date of birth [Date]

I am asking for a review of the decision dated [Date] that [I am / [Patient Name] is] not eligible for NHS Continuing Healthcare.

I believe [my / their] needs meet the eligibility criteria in the National Framework for NHS Continuing Healthcare. [My / Their] main need is a health need, and the assessment underestimated its nature, intensity, complexity and unpredictability.

Where the assessment went wrong:
• [e.g. "Behaviour" was scored low despite daily aggressive outbursts that need specialist help.]
• [e.g. the way "Mobility" and "Breathing" affect each other was not considered.]
• [e.g. the consultant's report dated [date] was not taken into account.]

Please send me a full copy of the Decision Support Tool, the assessment notes and your local review procedure.

If the decision is upheld after your review, I will ask NHS England for an independent review panel.

Yours sincerely,

[Your Signature]
[Your Printed Name]