A clear, structured framework to help you assess, prepare and submit a strong CHC appeal — written by someone who has been through it.
For many families, a CHC decision arrives at an already difficult time.
You may be facing:
Care home fees of £800–£1,500+ per week
Confusing terminology such as “Primary Health Need”
A lengthy document filled with domain scores and clinical language
A decision that feels inconsistent with the reality of daily care
The system is technical.
The stakes are often significant.
And most families enter the process without a clear framework.
This guide exists to provide that structure.
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A CHC decision can determine who pays for care — the NHS, or your family.
Typical care home fees range from £800 to £1,500 or more per week.
That is £40,000 to £80,000 per year.
If your loved one lives for another five years, the difference between CHC funding and self-funding may amount to £200,000–£400,000 or more.
Without CHC, those costs are usually met through:
Life savings
The sale of property
Family financial support
Appeals are not about “winning” money.
They are about ensuring the legal test has been applied correctly when the financial exposure is significant.
Where there are legitimate grounds, a structured challenge may be entirely proportionate.
Why I Created This Guide
In 2022, my mother suffered a series of catastrophic strokes. She became tetraplegic, bed-bound, largely PEG-fed and dependent on complex daily care.
For a period, she received NHS Continuing Healthcare funding. Then, following a review, it was withdrawn.
At that point, her care costs exceeded £2,100 per week. Within months, her life savings were gone. The local authority proposed moving her to a cheaper care home further away from family.
We decided to appeal.
Professionally, I have spent years analysing complex information and structuring detailed written arguments. I applied that same discipline to understanding the CHC framework.
I studied the National Framework.
I gathered medical records.
I mapped evidence against the Decision Support Tool.
I structured a clear, evidence-led submission.
Along the way, I realised how fragmented the available information can be — especially for families already under strain.
This guide is the resource I wish we had at the beginning.
It does not promise success.
It does not replace legal advice.
But it helps you approach the process calmly and methodically.
This guide is suitable if:
CHC funding has been refused or withdrawn
You believe the Decision Support Tool may understate needs
There are complex, interacting health conditions
You are prepared to approach the appeal methodically
It may not be appropriate if:
Care needs are primarily routine daily living support
There are no identifiable weaknesses in the assessment
You are seeking guaranteed outcomes
Clarity at the outset prevents unnecessary stress.