Running the Local Resolution Meeting: 11 Plays Families Use to Reverse a CHC Refusal

A CHC refusal lands as a letter, but it is reversed in a room. Local resolution is the first formal stage of appeal, and it is the most winnable one you will get — because, unlike every stage above it, you can still put new evidence on the table. The trouble is that most families walk in to argue and walk out having lost, because they treated a structured evidence review like a conversation about how unfair the decision felt.

This is a play-by-play for that room. Eleven concrete moves — what to do before, during, and after the meeting — built on what the National Framework and NHS England actually require, not on hope.

Reviewed by legal professionals and social care professionals.

TL;DR: Local resolution is the ICB reviewing its own CHC decision, and it is the one appeal stage where new evidence is still welcome (National Framework, 2022). Only 13% of requests succeed nationally (Nuffield Trust, 2024) — but that average is dragged down by unprepared submissions. Win the room by mapping every dispute to a DST domain, speaking in frequencies not adjectives, and getting the written outcome with reasons. No solicitor required.

What this guide does not cover

This is the tactical guide to the meeting itself — the eleven plays families use in the room. It assumes you've had a "not eligible" decision and want to overturn it at Stage 1. It deliberately doesn't re-explain ground covered elsewhere. For the full appeal ladder from the refusal letter through to the Ombudsman, start with how to appeal a CHC decision. For the structure and wording of the written submission, see what to include in a CHC appeal letter. For the deadlines that govern every stage, see the CHC appeal time limits guide. For the prior question — is this case even worth pursuing? — see whether it's worth appealing. And for the next stage up if local resolution fails, see inside the IRP hearing.

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Why is the local resolution meeting winnable?

Local resolution overturns about 13% of refusals nationally — 596 requests in Q4 2023/24, of which 13% resulted in eligibility (Nuffield Trust, June 2024). That sounds low, and on raw numbers it is. But it's a national average across every submission — including the many that arrive as a paragraph of disagreement with no new evidence attached. The base rate isn't your rate.

Here's why the stage matters more than its headline figure suggests. The bar at the front door is already brutal: just 21% of people assessed for standard CHC were found eligible in Q4 2023/24, down from 27% in 2017 (Nuffield Trust, 2024). Most refusals are systemic, not personal. And local resolution is the one appeal stage where you can still fix what the original assessment missed — because you're allowed to bring evidence it never saw.

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Before the meeting: plays 1–4

The meeting is won before anyone sits down. Local resolution starts with an attempt to resolve concerns through discussion, then — if needed — a formal meeting with someone who holds ICB decision-making authority (National Framework, 2022, para 215). What you bring to that meeting is decided in the weeks before it.

Play 1 — Get the records before you argue

You cannot challenge a DST score you haven't read the evidence behind. Submit a Subject Access Request to the GP, hospital, ICB and care home for the full assessment file the moment you decide to appeal. Without the records, you're arguing from memory; with them, every claim is dated and sourced. The records have to come first — they are the raw material for every play that follows.

Play 2 — Map every dispute to a DST domain and a characteristic

Don't dispute the decision in general; dispute it domain by domain. Each of the 12 DST domains is scored against published descriptors, and your job is to show that the recorded evidence supports a higher level than the ICB awarded. Tie each domain back to the four characteristics the National Framework uses to find a primary health need — nature, intensity, complexity and unpredictability (para 60). A score that ignores documented unpredictability is a score you can move.

Play 3 — Bring new evidence (and know you're allowed to)

This is the play that separates local resolution from everything above it. The National Framework explicitly makes Stage 1 "an opportunity for the individual or their representative to provide any further information that had not been considered" (para 215). Contrast that with the IRP, where you can only introduce new evidence the ICB unreasonably failed to obtain. Translation: the records, incident logs and specialist letters you wish the assessor had seen belong here, now — not saved for a later stage that won't take them.

Play 4 — Send a written submission ahead, don't wing it

Put your case in writing before the meeting, structured domain by domain, and send it in advance. A written submission does two things a verbal argument can't: it gives the senior reviewer time to actually read your evidence, and it creates a record that survives the room. Walking in with a folder you've never summarised is how strong cases get talked past. The appeal letter guide covers the structure; the meeting is where you defend it.

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In the room: plays 5–9

The formal meeting involves someone with authority to act for the ICB — to request further reports, seek clarification, or send the case back to the MDT (National Framework, 2022, para 215). It typically runs two to three hours, in person or on Teams, working through each disputed domain. These five plays are what you actually do once it starts.

Play 5 — Bring a named advocate or representative

You're entitled to bring a representative — a family member, an unpaid carer, someone with Lasting Power of Attorney, or an organisation acting for you (National Framework, 2022). Don't go alone if you can help it. A second person tracks what's said, holds the structure when the conversation drifts, and notices the moment a fluctuating need gets quietly recorded as "stable." Grief and authority are a bad combination across a table; a prepared advocate steadies both.

Play 6 — Speak in frequencies, not adjectives

This single habit changes how a panel hears you. NHS England's own guidance is unusually blunt: be specific, because it helps "much more if you say that a problem happened 'usually two or three times a day' than if you say it happened 'a lot'" (NHS England, 2023). "A lot," "often," "really difficult" — these invite a lower score. "Three falls in fourteen days, all logged" doesn't. Convert every adjective in your case into a dated number before you walk in.

Play 7 — Work domain by domain, descriptor by descriptor

Resist the urge to tell the whole story at once. Take the disputed domains one at a time, and for each, read the ICB's recorded level against the published descriptor, then show the evidence that supports the level above. Don't assert "this should be severe" — show the dated entries that meet the severe descriptor and let the reviewer draw the line. A panel remembers three precise, descriptor-anchored domain arguments far better than thirty general grievances.

Play 8 — Surface the needs that look "well-managed"

The most common way a real need disappears from a DST is that good care hides it. A seizure controlled by medication, aggression contained by two-to-one supervision, a pressure risk held off by hourly turns — all can be scored down as if the underlying need were mild. The National Framework is clear that needs should be assessed as they would present without that management. Name it directly: read our breakdown of well-managed needs and bring the care that's doing the hiding into the open.

Play 9 — Put process failures on the record

Evidence wins eligibility, but process points explain why the ICB missed it — and they matter later. Did the assessment rest on a single snapshot rather than the run of records? Was a domain scored without the care home notes? Was the primary health need test applied as a checklist rather than a holistic judgement? State each one plainly and ask for it to be minuted. If local resolution fails, these are the threads the IRP and Ombudsman pull.

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After the meeting: plays 10–11

The ICB cannot decide in the room. Following the formal meeting it will "either uphold or change the original eligibility decision" in writing (National Framework, 2022, para 215). The final two plays are about protecting your position once the meeting ends.

Play 10 — Demand the written outcome, with reasons

You're entitled to a full written record of the formal meeting and a reasoned outcome — normally within about four weeks. Three results are possible: the decision stands, a full reassessment is convened, or the decision is reversed. If the outcome is a refusal, the reasons are what you'll challenge next, so read them against your submission. A decision that doesn't engage with evidence you put forward is itself a process failure worth flagging.

Play 11 — If it fails, start the IRP clock immediately

A refusal at local resolution is not the end — it's the trigger for Stage 2. You typically have six months from the local resolution outcome letter to ask NHS England for an Independent Review, though deadlines are governed by published policy, so confirm yours. Don't let the disappointment cost you the window. Read inside the IRP hearing for what comes next, and the appeal time limits guide for every date that matters.

A de-identified example from our casework shows how the plays compound. A family disputed the Behaviour domain, which the ICB had recorded as "moderate." Before the meeting they assembled 14 dated incident reports over six months, each describing unpredictable aggression needing two-person intervention, and mapped them to the high and severe descriptors and to the unpredictability characteristic. In the room, they took Behaviour alone, in frequencies, and asked for the records' contradiction of "stable presentation" to be minuted. The submission never asserted the higher level — it showed the evidence that supported it.

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What this means for your meeting

Strip local resolution back and it comes down to one reframe: this is the last stage that will take new evidence, so this is where the case is actually built. The 13% national figure describes unprepared submissions, not yours. Map every dispute to a domain and a characteristic, speak in dated frequencies, surface the needs that good care is hiding, and get the reasons in writing whichever way it goes.

None of it requires a solicitor — local resolution is an evidence exercise, not a courtroom. All of it requires structure, and most of that structure is built in the weeks before the meeting, not improvised across the table.

CareAdvocate is an evidence preparation service, not a legal recovery firm, and we don't guarantee outcomes. If you want a quick read on whether the underlying case supports a primary health need, start with the free CHC eligibility screener. For a structured, evidence-strength view before you commit dozens of hours to a submission, our Case Strength Report at £97 gives a five-day assessment — and a stronger, domain-mapped case is exactly what a local resolution meeting rewards.

Continue learning

• How to appeal a CHC decision: the complete family guide — the full two-stage route, start to finish
• What to include in a CHC appeal letter — the structure of the written submission you'll defend in the room
• Inside the CHC IRP hearing — the next stage if local resolution fails
• CHC appeal time limits: the 6-month rule — every deadline that governs the process
• Well-managed needs explained — how good care hides a real need, and how to surface it

Frequently asked questions

How many CHC local resolution requests succeed?

In Q4 2023/24 there were 596 local resolution requests and 13% resulted in eligibility — roughly one in eight ICB decisions overturned at first review (Nuffield Trust, June 2024). It is a national average on mixed-quality submissions; a structured, domain-mapped evidence pack performs meaningfully better.

Can you bring new evidence to a CHC local resolution meeting?

Yes. The National Framework (2022, para 215) makes local resolution an opportunity to provide information that had not been considered. This is the key difference from the Independent Review Panel, where new evidence is heavily restricted. Local resolution is the stage to put fresh records on the table.

What should you say at a CHC local resolution meeting?

Speak in frequencies, not adjectives. NHS England's own guidance says it helps far more to say a problem happened 'usually two or three times a day' than 'a lot' (NHS England, 2023). Work domain by domain against the published descriptors and cite dated records, not impressions.

How long do you have to request CHC local resolution?

ICBs typically allow six months from the date of your eligibility decision letter, but the National Framework defers the exact deadline to each ICB's published local resolution policy. Check your ICB's policy and request the review in writing as early as you can.

Do you need a solicitor for a CHC local resolution meeting?

No. Local resolution is an evidence review, not a legal process, and the NHS does not reimburse solicitor costs. Most successful family appeals turn on a structured, DST-domain evidence pack and a named advocate in the room — not legal representation.