Act quickly if you want to make a retrospective claim for care home fees that have been wrongfully denied


On the 15th March 2012, the Department of Health (DoH) announced its intention to introduce a close down for any new cases to the system for retrospective assessment of eligibility for NHS Continuing Healthcare funding (CHCF).

The Department of Health requires the individual or their representative to notify their relevant Primary Care Trust of previously un-assessed periods of time where there is evidence the individual should have been assessed for eligibility for NHS continuing healthcare funding.

The letter from Sir David Nicholson, NHS Chief Executive, sets out the three separate time periods with two deadlines that will be applied to retrospective claims:

Time Period Deadline
1st April 2004 - 30th September 2007 30th September 2012
1st October 2007 - 31st March 2011 30th September 2012
1st April 2011 - 31st March 2012 31st March 2013

The DoH indicates that late applications will only be considered in "exceptional circumstances". What these circumstances are will be down to the individual Primary Healthcare Trusts, thus potentially leading to "postcode lottery? decision-making. Unfortunately, the Department has not included any guidance on what might be considered exceptional.

If you think that you, a friend or relative have been wrongly denied NHS continuing healthcare funding, it is essential that you act quickly and certainly no later that the timeframes outlined above. NHS Primary Care Trusts must receive requests for retrospective reviews before the deadlines set.

Further information can be found on the DoH's website (

For bespoke advice, please feel free to contact us.

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