What's the Time Limit on a CHC Appeal? The 6-Month Rule Explained

Only 17% of people assessed for NHS Continuing Healthcare are now found eligible at full assessment — down from 31% in Q1 2017/18 (Healthwatch England, October 2025). If a "not eligible" letter has just arrived, the clock is already running. The single most expensive misconception families have about CHC appeals is that the deadline begins when the letter arrives. It does not — it begins on the date printed at the top.

This guide gives the exact statutory deadlines, the date the clock starts in edge cases, what to do if the deadline has been missed, and the first 30 days of work that decide most appeals. It is the deep companion to our complete guide to appealing a CHC decision; read this one if the question on your mind is how long do I have.

Reviewed by legal professionals and social care professionals.

TL;DR: Under the 2022 National Framework, you have 6 months from the date on the ICB's CHC decision letter to request Local Resolution. If that fails, you have a further 6 months from the Local Resolution outcome letter to request an Independent Review Panel (IRP) at NHS England. After the IRP, you have 12 months to complain to the Parliamentary and Health Service Ombudsman. ICBs may accept late appeals in "exceptional circumstances" but are under no statutory obligation. Missing the 6-month window does not automatically end the case — four fallback routes remain.

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How long do you have to appeal a CHC decision?

Six months from the date on the ICB's eligibility decision letter to request Local Resolution (Stage 1 of the appeal process). This is set out in the 2022 National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, the statutory guidance under the Care Act 2014. ICBs are required to follow it, and courts treat the Framework as binding.

The deadline is for submitting the request, not for completing the review. A written request received by the ICB within the six-month window keeps the appeal alive even if the Local Resolution Meeting itself takes place months later. That distinction matters: families sometimes assume they need the full evidence pack assembled before they can request a review. They do not. The request can be a short letter that names the decision being appealed, identifies the disputed DST domains, and asks for a Subject Access Request to the case file at the same time. The full grounds and evidence can follow.

The same Framework applies across England. Wales operates a separate system through Local Health Boards under the National Framework for Implementation of Continuing NHS Healthcare in Wales, and Scotland and Northern Ireland have their own arrangements. The 6-month rule described here is the English position; check the equivalent guidance for the devolved nations.

CHC appeal deadlines at a glance

Two practical points the table cannot capture. Missing the Local Resolution window does not automatically end the case — ICB discretion, a retrospective claim under PUPoC, a fresh referral if needs have changed, and the PHSO route all remain available in different circumstances. And the deadlines are all for submitting the request, not for completing it — a written request in time stops the clock; the meeting itself can be months later.

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When does the 6-month CHC appeal clock start?

The clock starts on the date printed on the ICB's eligibility decision letter — not the date the letter was received, opened, or understood. If the letter is dated 1 March, the Local Resolution deadline is 1 September. Postal delay does not reset the clock. Misdirected post — to a care home, a different family member, or an outdated address — does not reset the clock either.

There is one practical exception worth knowing about. If the letter genuinely never reached the person it was addressed to, and the ICB can be shown to have used an incorrect or stale address, the family can ask for the clock to run from the date of actual receipt. This is not a statutory right; it is an appeal to the ICB's discretion. It is much easier to argue with documentary evidence — the envelope (keep it), a redirected postal certificate, or a written communication to the ICB about the correct address that pre-dates the decision letter.

For most families the safe assumption is that the clock starts on the letter date. Note that date in writing on day one. Diary the six-month deadline at the same time. The single most common cause of a missed deadline is not knowing when it falls.

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What happens if you miss the 6-month deadline?

Missing the 6-month deadline does not automatically end the case. The 2022 National Framework allows ICBs to accept late appeals in "exceptional circumstances", and three further routes remain open: a fresh referral for a new CHC assessment, a retrospective claim under the Previously Unassessed Period of Care (PUPoC) process, and a complaint to the Parliamentary and Health Service Ombudsman.

ICB discretion is the first route and the simplest. Write to the ICB explaining the delay, naming the original decision being appealed, and asking explicitly for discretion to be exercised. "Exceptional circumstances" in ICB practice typically means bereavement, serious illness affecting the person making the appeal, evidence that the original decision letter was not received, or that the family did not have access to the records on which to base an appeal. Beacon CHC reports that the practical deadlines imposed by individual ICBs vary widely — from two weeks to the full six months, with some refusing late appeals without giving reasons. Approach the request as a structured argument, not a plea.

A fresh referral for a new CHC assessment is the second route. This is appropriate where the person's needs have changed materially since the original assessment — a new diagnosis, a hospital admission, a step-up in care intensity. It is not an appeal of the original decision; it is a request for a new one. The decision being challenged remains in force, but a new assessment can produce a different outcome.

A PUPoC claim is the third route — a retrospective claim for past unfunded care fees, separate from the appeal process. PUPoC has its own deadline windows and procedure. For families who have already paid significant care home or nursing fees during a period when CHC eligibility may have been wrongly refused, this is often the more financially significant route. See our retrospective CHC claim guide for the detail.

The PHSO is the fourth route, addressed in the dedicated section below.

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How long do you have to request an Independent Review Panel (IRP)?

A further six months from the date of the Local Resolution outcome letter to request an Independent Review Panel from NHS England (NHS England Independent Review Process — public information guide, 2020). The IRP is Stage 2 of the appeal process and is administered nationally by NHS England — independently of the ICB.

The IRP request goes to NHS England, not back to the ICB. Once the request is submitted, families have approximately six weeks to lodge all written evidence with NHS England. The hearing itself, typically held on Microsoft Teams, lasts about two hours. The panel reviews the original ICB process, the DST scoring, and the eligibility decision against the National Framework; it cannot commission new clinical assessments, but it can recommend the ICB reconsider, make findings of process failure, or — in exceptional cases — directly recommend eligibility.

Two practical points. First, NHS England has discretion to refuse to convene a panel if the request is out of time or lacks substantive grounds; submit on time and be specific. Second, the six-week evidence window is a hard constraint. Families who have used the Local Resolution stage to assemble their evidence pack arrive at the IRP with most of the work done; families who treated Local Resolution as a casual first round find the IRP timeline impossible. For the full mechanics of the IRP hearing, see the IRP section of our complete CHC appeal guide.

One transparency note: NHS England does not publish a national overturn rate for the IRP stage — a notable gap given the volume of cases. Commercial providers cite a range of figures, but the primary-source data is missing. Ask any paid provider what overturn rate they quote and what it is sourced to before you commit.

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Can the ICB refuse to accept a late CHC appeal?

Yes. The ICB has discretion, not an obligation, to accept appeals submitted after the six-month deadline. In Beacon CHC's published commentary on family experience, the practical deadlines imposed by individual ICBs range from two weeks to six months, and some refuse late appeals without giving substantive reasons. The Framework gives the discretion; how an ICB exercises it varies by area and sometimes by appeals officer.

If a late appeal is refused, three follow-up options exist. The first is to formally complain through the ICB's own complaints procedure, citing the National Framework and any specific welfare grounds for the delay. The second is to escalate to NHS England, which oversees ICB performance and can intervene in egregious cases. The third is the PHSO route, which exists precisely to investigate maladministration — including unreasonable refusals to engage with the appeal process.

The practical implication is simple: the safest strategy is to get the appeal request in early, ideally within the first 30 days, regardless of when the deadline falls. For more on why ICB practice varies so widely, see our analysis of how ICB policies vary on CHC eligibility.

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What's the deadline to complain to the Ombudsman about a CHC decision?

Twelve months from the date of the final NHS appeal outcome (typically the IRP letter, or in some cases the Local Resolution outcome where the IRP route is not pursued) to bring a complaint to the Parliamentary and Health Service Ombudsman. The PHSO investigates maladministration — process failures, unreasonable delay, breakdowns in fairness — rather than re-deciding eligibility on the same facts.

What the PHSO can do: recommend reconsideration of a CHC decision; recommend financial redress for distress, inconvenience, or wasted private fees; recommend a public apology; recommend policy or training change at the ICB. What the PHSO cannot do: directly award CHC funding. The PHSO will normally only investigate after the NHS's own complaints process has been exhausted, which in CHC terms means Local Resolution at minimum and usually IRP as well.

CareAdvocate is an evidence-preparation service, not a regulated legal advisor. For Ombudsman complaints, free advocacy is available through Beacon CHC's NHS-funded information service (beaconchc.co.uk), through Action Against Medical Accidents (AvMA), or through a solicitor with public-law experience in health and social care. The PHSO route is a last resort, but it exists precisely for the cases the rest of the system fails.

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What should you do in the first 30 days after a CHC refusal?

The first 30 days are the highest-leverage period in any CHC appeal. By day 30, the family should have: (1) submitted a Subject Access Request for the underlying records, (2) requested a copy of the DST and any panel notes from the original assessment, (3) drafted the grounds of appeal, and (4) filed the Local Resolution request — without waiting for full evidence to arrive. The Local Resolution request can precede the evidence; the evidence builds during Local Resolution.

A workable 30-day plan:

• Day 1 — Read the letter and note the date. Mark the six-month deadline in writing. Note the disputed DST domain levels (these are the targets for the appeal).
• Day 1–3 — File the Subject Access Request. Use the SAR letter pack or our SAR family guide. The ICB has one calendar month to respond.
• Day 7–14 — Request the DST and panel notes separately if not returned in the SAR. Confirm in writing that the family was the recipient of the original decision.
• Day 14–28 — Draft the grounds of appeal. Identify the disputed domains, the descriptor levels the evidence supports, and any process failures (missing records, incomplete MDT, no Coordinating Assessor).
• By Day 30 — File the Local Resolution request in writing, recorded delivery, with a copy retained. The full evidence pack can follow; the request itself stops the clock.

If you are not yet sure the case is worth appealing — and many families correctly conclude after seeing the records that it is not — the free CHC eligibility screener takes four minutes. For a five-day, evidence-strength view written by a human reviewer, the Case Strength Report at £97 is designed to answer "is this worth pursuing?" before the family commits another 60 hours of work.

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What this means for your next six months

The six-month rule is the headline, but the timing structure underneath it is what actually decides cases. Local Resolution within six months; IRP within a further six; PHSO within twelve months of the final NHS outcome. Three statutory windows, three different bodies, three different evidence rules. Missing the first window is not terminal — discretion, fresh referral, PUPoC and the PHSO route all remain.

The two highest-leverage moves are the same in every case. Note the deadline on day one, in writing, on the family's calendar. And file the Local Resolution request early — within 30 days if possible — even before the full evidence has arrived. Both are free, both take less than an hour, and both turn the rest of the appeal process from an emergency into a project.

For the full procedural map of the appeal route, see our complete guide on how to appeal a CHC decision. For a quick view of whether your case is worth appealing in the first place, the free CHC eligibility screener is the place to start.

This guide is reviewed by legal professionals and social care professionals. CareAdvocate provides advocacy and evidence preparation, not legal advice. Time limits referenced are taken from the 2022 National Framework and current NHS England guidance; individual ICB practice on late-appeal discretion varies, and no outcome is guaranteed.