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NHS Continuing Healthcare Independent Review Panels: how to prepare.

If an Integrated Care Board has upheld a refusal through its local resolution process, the next stage may be an independent review arranged by NHS England. This is not simply another meeting: it is a structured review of whether the eligibility process and decision were properly reached.

Where an IRP fits

First, the ICB should have had the opportunity to try to resolve the dispute through local resolution. If the matter remains unresolved, the individual or representative can ask NHS England to arrange an independent review.

Who sits on the panel?

Independent chair

The panel is led by an independent chair. NHS England may also seek independent clinical advice where required.

Independent participants

The panel includes an ICB representative and a local authority representative who were not involved in the case. A clinical adviser may also attend.

What happens before the panel?

01

Request the review

After local resolution, the NHS England public guide says the application form should be returned within six weeks so the request can progress.

02

NHS England considers the application

The case may go through a consideration process before NHS England decides whether a full independent review panel should be arranged.

03

The evidence is assembled

The strongest submissions are organised around the actual eligibility question: what the needs were at the relevant time, how the domains were scored and how nature, intensity, complexity and unpredictability were treated.

04

The panel meets

NHS England says IRPs are normally held virtually on Microsoft Teams, although telephone, face-to-face or hybrid arrangements can be considered case by case.

What should the family focus on?

  • The precise reasons the ICB gave for refusing eligibility.
  • Any disagreement between the care records and the DST scoring.
  • Needs that were treated in isolation when their interaction created complexity.
  • Risks or interventions that disappeared from the assessment because successful care prevented incidents.
  • Changes between contemporaneous records and later summaries.
  • Procedural failures that materially affected the assessment or decision.

Do not turn the submission into a document dump

An IRP needs a clear theory of the case. The goal is to show, with references to the evidence, why the decision did not properly reflect the needs or the National Framework. A chronological bundle is useful; a focused argument tied to the evidence is better.

What an IRP cannot decide

NHS England's public guide makes clear that the independent review process is about the CHC eligibility decision. It does not determine every dispute connected with care, and it is not the route for challenging an ICB's refusal to carry out a full assessment following a negative Checklist.

What happens after the panel?

The panel makes a recommendation and NHS England communicates its decision. If the individual still disagrees, the next available route may involve the Parliamentary and Health Service Ombudsman, depending on the issue and circumstances.

Primary sources: NHS England — Continuing Healthcare and independent review · NHS England — Independent review public information guide

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