If you receive a letter saying you are “not eligible” for CHC funding and you feel that the appropriate procedures have not been followed, for example, that our team at West Hampshire CCG have not applied the National Framework appropriately in making this decision, or your needs have been misrepresented, you have a right to appeal. You should do this within six months of receiving your decision letter. If you would like to appeal a decision you can request this in writing by contacting us as below:
NHS Continuing Healthcare and NHS-funded Nursing Care Team
5th floor, Civic Offices
Civic Way, Fareham
Hampshire, PO16 7AZ
WHCCG.continuingcare@nhs.net
The NHS Continuing Healthcare team in Hampshire will arrange a Local Review Meeting (LRM) with you within 35 days of the request to discuss the appeal and your views on the health needs of the individual concerned.
Following this a Specialist Practitioner will review all of the evidence, including the evidence you provide and will produce an appeals document and recommendation as to whether the original decision was sound.
If the original decision is overturned and you are found eligible the CCG will seek to provide reimbursement.
If you are unhappy with the outcome of the LRM you can refer your case to an Independent Review Panel (IRP). If you would like to refer your case, you will need to write directly to the NHS Commissioning Board in the south region for an Independent Review Panel form:
Ms Sally-Anne Parry
NHS England Continuing Healthcare Team (South) South West House Blackbrook Park Avenue TAUNTON TA1 2PX
Telephone: 01823 361000
Email: england.south-chc@nhs.net