The Independent Review Panel (IRP), Explained in Plain English

By Len Burgess, Senior Care Advisor · Published 14 May 2026

If you search "Independent Review Panel," you'll get a lot of results about school exclusions; that's a different IRP entirely. This post is about the Independent Review Panel for NHS Continuing Healthcare (CHC), the panel that reviews refused care funding decisions.

This is part of our Jargon Buster series, which covers your last formal chance to overturn a refused CHC decision, what the Independent Review Panel is, who sits on it, and how to give yourself the best possible shot.


A quick note before we start. If you search "Independent Review Panel," you'll get a lot of results about school exclusions; that's a different IRP entirely. This post is about the Independent Review Panel for NHS Continuing Healthcare (CHC), the panel that reviews refused care funding decisions.


If you've read our previous posts on CHC and the CHC assessment, you'll know that NHS Continuing Healthcare is fully funded care for people whose main need is a health need, and that the assessment process turns most applicants down. There's an appeal route, and the IRP is its second and final formal stage. For many families, it's where a wrongly refused decision finally gets put right.


What is the Independent Review Panel?

The Independent Review Panel (IRP) is a formal appeal panel, run by NHS England, that reviews a decision to refuse someone NHS Continuing Healthcare funding.


The keyword is independent. Up to this point in the CHC process, every decision has been made by your local Integrated Care Board (ICB), the NHS body that both assesses eligibility and holds the budget.


That's a built-in conflict of interest, and it's exactly why the IRP exists. The IRP takes the decision out of the ICB's hands and gives it to a panel of people from outside your area, coordinated by NHS England's regional CHC teams.


It's important to understand where the IRP sits in the overall appeals process:


  1. The original decision — your ICB completes a CHC assessment and decides you're not eligible
  2. Local Resolution — you challenge that decision with the same ICB (the first appeal stage)
  3. The Independent Review Panel — if Local Resolution fails, NHS England convenes an IRP (the second and final formal appeal stage)
  4. The Parliamentary and Health Service Ombudsman — the last resort, available only after the IRP


So the IRP isn't the start of a fight; it's the stage you reach after the ICB has turned you down twice. That sounds discouraging, but it shouldn't be: it's the first time genuinely independent people look at your case.


One crucial limitation to know upfront: you can't appeal to an IRP simply because you disagree with the outcome. You have to show one of two things: that the correct process wasn't followed, or that the person's care needs weren't properly assessed.


How does the IRP work?

Here's the journey from refused Local Resolution to IRP decision.


Requesting the IRP

After your Local Resolution is unsuccessful, the ICB must tell you, usually in the decision letter, that you have the right to request an Independent Review, and who to contact: your regional NHS England CHC team (there are seven regions in England).


You have six months from the date of the Local Resolution outcome to request an IRP. Don't be pressured into deciding on the spot, but don't sit on it either, and when you request it, put your full case in writing, because NHS England may not accept further submissions later.


If you're requesting an IRP on behalf of someone else, you'll need to show your authority to act: a health and welfare Lasting Power of Attorney, a Court of Protection deputyship, or, if the person has died, proof you're the executor or have a legal interest in the estate.


Before the panel

Once your case is accepted, NHS England's regional team coordinates everything. The independent chair reviews the case first to confirm a full panel should go ahead.


You'll be sent a "panel pack", copies of the original assessment, the records the ICB is relying on, and documents from the Local Resolution stage. You'll also be invited to make written submissions. If the pack hasn't arrived around two weeks before the hearing, chase it.


You are not required to attend the panel; you can submit your views in writing, but we strongly recommend you do. As a family member, you can give the panel details about the person's day-to-day needs that simply aren't captured in medical records.


The hearing itself

IRPs are normally held online via Microsoft Teams, though you can request a telephone, face-to-face, or hybrid format, and NHS England will consider it on a case-by-case basis. The hearing typically lasts around two hours.


The chair opens by introducing everyone and explaining how the meeting will run. Then both sides, you (or your representative) and the ICB's representative, present their case and discuss the disputed assessment in an open forum, with the chair making sure everyone gets a fair chance to contribute.


Once the open discussion is finished, you and the ICB representative are asked to leave, and the panel deliberates in private before producing its decision.


The decision

You'll usually receive the panel's written report around six to eight weeks after the hearing. It sets out whether the ICB's original decision was sound, whether the person should be found eligible for CHC, and any comments on how the ICB handled the process.


Technically, the IRP only makes a recommendation to the ICB; it can't force the ICB's hand. But in practice, ICBs almost always accept the IRP's findings.


If the IRP still finds against you, that's not quite the end. You can take your case to the Parliamentary and Health Service Ombudsman, or in some cases, consider judicial review.


Who sits on the panel?

This matters more than people realise, because "independent" has a specific meaning here. An IRP has three decision-makers:



There may also be a clinical advisor in attendance, but in a non-decision-making role; they advise, they don't vote. And there's usually an administrator from NHS England taking notes, who also doesn't make decisions.


The logic: CHC assessments are multi-disciplinary, so the panel reviewing them must be too, combining health and social care expertise. And because everyone with a vote comes from outside your area, none has a stake in your ICB's budget.


A note of realism, because this series is about plain truth: some families report that IRPs don't always feel as independent as they should, for example, when the same local assessors whose work is under review are invited to attend. Independence is the design; it isn't always the lived experience. That makes thorough preparation even more important.


What are your chances at an IRP?

Here's the honest picture. NHS England doesn't routinely publish IRP success rates in an accessible way, so there's no single clean national figure.


What we can say is this:

Around 13–25% of appeals succeed at the earlier Local Resolution stage, so by the time you reach an IRP, you're already in the group whose cases weren't resolved. That can feel disheartening, but it cuts both ways: a refusal at Local Resolution often reflects the ICB defending its own decision, not an independent judgment of the evidence.


Specialist representation appears to make a substantial difference. Organisations and law firms that handle large volumes of IRPs report success rates well above the headline averages, in some cases 70% or higher for the cases they take on. That's not secret influence; it's because they know exactly what an IRP is looking for and how to present it.


The single most important factor in your chances is whether you can clearly demonstrate a specific failing, either in the process the ICB followed, or in how the person's needs were assessed. "We think the decision is wrong" rarely succeeds. "The ICB scored the Behaviour domain as Moderate despite documented daily incidents in the care notes, and didn't properly apply the Unpredictability indicator" is the kind of argument that wins.


Who tends to be successful at an IRP?

A pattern emerges from the cases that succeed.


People who identify concrete process failures. Care records that weren't requested or considered, family members not invited to the assessment, no clear rationale for disputed domain scores, and the four key indicators not properly applied are the failings IRPs are specifically there to catch.


People with strong, organised evidence. GP and consultant letters, the full care plan, daily care notes, incident and behaviour logs, medication charts, and specialist reports. The IRP can only work with what it sees, and well-organised evidence is far more persuasive than a box of unsorted paperwork.


People who attend and speak. Families who attend the hearing and describe the reality of day-to-day care, the things that never make it into clinical notes, consistently do better than those who rely on written submissions alone.


People who frame their case in the language of the framework. The IRP reviews the decision against the National Framework for NHS Continuing Healthcare. Arguments grounded in its own concepts, primary health needs, the four key indicators, and the 12 care domains are far better than emotional appeals, however genuine.


People who get help. Free support is available from Beacon CHC (the NHS-funded advice service, delivered with Age UK, Parkinson's UK and others), as well as Age UK and Citizens Advice. You can also instruct a specialist solicitor or CHC consultant, though you should never need to pay to get a fair hearing.


Where people struggle: when the appeal rests on disagreement rather than a demonstrable error, when evidence is thin or disorganised, or when the argument is about how unfair the situation feels rather than where the assessment specifically went wrong.


How does this apply to me?

The questions below are the ones families ask when they reach this stage.


1. What exactly is the IRP — and how is it different from the local appeal?

The local appeal — Local Resolution — is run by the same ICB that refused you. The team reviewing the decision works for the organisation that made it, and holds the budget from which the funding would come from.


The Independent Review Panel is run by NHS England, not your ICB. Its three decision-makers all come from outside your area, and the chair doesn't work for the NHS at all. It's the first point in the entire CHC process where genuinely independent people look at your case.


In short, Local Resolution is the NHS marking its own homework. The IRP is supposed to be a fresh, independent set of eyes.


2. What does the IRP actually review — the decision, or the process?

Both, and this is one of the most useful things to understand.


The IRP reviews two separate things: the eligibility decision itself (did the person actually have a primary health need?), and the procedure the ICB followed in reaching it (was the assessment carried out properly and fairly?).


This matters because it gives you two routes to success. Even if the clinical picture is genuinely borderline, a serious procedural failure, ignored evidence, an assessment the family wasn't invited to, or unexplained scoring can be enough for the IRP to find the original decision unsound.


3. Who can request an IRP, and what's the deadline?

The right to request an IRP belongs to the individual or their representative.


If you're acting for someone else, you'll need to prove your authority: a health and welfare Lasting Power of Attorney, a Court of Protection deputyship, or, if the person has died, evidence you're the executor or otherwise have a legitimate interest in their estate. This last point matters because many CHC appeals (including retrospective ones) are pursued after someone has passed away.


The deadline is six months from the date you're notified of the Local Resolution outcome. Request it in writing to your regional NHS England CHC team, and include your full case; don't assume you'll get another chance to add to it.


4. What are the benefits of taking my case to an IRP?

Several, and they're worth being clear about.


The obvious one: it's a genuine chance to overturn the refusal and secure full NHS funding, which, for someone in a nursing home, can be worth £50,000 or more a year, with no means test.


But there are others. An IRP can result in backdated funding; if the person is found eligible, funding is typically backdated to when they should have been receiving it, which can mean a substantial refund of fees already paid. The IRP can also formally criticise the ICB's process, strengthening your position if you escalate further. And reaching the IRP preserves your right to go to the Ombudsman afterwards; you can't skip this stage and still use that final route.


Even the preparation has value: pulling your evidence together for an IRP often surfaces gaps and errors in the original assessment you can point to directly.


5. What happens if the IRP still says no?

It's not necessarily the end.


If the IRP upholds the refusal, you can ask the Parliamentary and Health Service Ombudsman (PHSO) to investigate whether there's been maladministration or service failure in how your case was handled. In some circumstances, judicial review, a legal challenge to the lawfulness of the decision, may also be an option, though that's a significant step and you'd want specialist legal advice first.


It's also worth remembering that CHC eligibility isn't permanent or one-time. If the person's needs change or worsen, a fresh assessment can be requested; a "no" today doesn't bar a future "yes."


The takeaway

The Independent Review Panel is the point in the CHC process where the system finally builds in genuine independence — a panel from outside your area, chaired by someone who doesn't work for the NHS, reviewing both the decision and the way it was made.


It isn't a rubber stamp, and it isn't a lost cause. The families who succeed treat it as what it is: a structured review that responds to specific, evidence-based arguments about where the original assessment went wrong. Identify the failings, organise the evidence, attend the hearing, speak plainly about the reality of care, and use the language of the National Framework.


And get help, it's free. Beacon CHC, Age UK, and Citizens Advice can all support you, and you should never have to pay simply to be heard fairly.


Use our funding calculator to see what a successful CHC outcome would mean for your overall care costs. And look out for the next post in this series, where we'll tackle the £86,000 care cost cap.


This article is for general guidance only and reflects the NHS Continuing Healthcare independent review process in England as of 2026. Wales operates a similar but separate system; Scotland phased out CHC in 2015; Northern Ireland uses a different framework. For tailored advice, contact your regional NHS England CHC team, Beacon CHC, Age UK, or Citizens Advice. You should never need to pay for help with a CHC appeal.

Sources

Frequently asked questions

How long does the whole IRP process take?

There's no fixed timetable, and it varies by region, but a realistic expectation is several months from requesting the panel to receiving the decision. NHS England's regional team needs time to gather the case file, coordinate the panel members, and schedule a date, and the hearing itself is only booked once the case is confirmed ready. After the hearing, the written decision report usually arrives around six to eight weeks later. If your case seems to be stalling with no clear explanation, contact your regional NHS England CHC team and ask for a progress update in writing.

Can I bring someone with me to the IRP hearing?

Yes, and you should. You can bring a family member, a friend, an advocate, or a professional representative such as a specialist solicitor or CHC consultant. Having someone alongside you matters because IRP hearings, though they're meant to be welcoming and not overly formal, can feel intimidating, with several professionals in the (virtual) room. A second person can help you stay on track, take notes, and make sure points aren't missed. Free advocacy support is available through Beacon CHC and Age UK, so you don't need to pay for representation to have someone in your corner.

Will I have to pay anything to go to an Independent Review Panel?

No. Requesting and attending an IRP is free, it's a statutory part of the NHS Continuing Healthcare process, and NHS England coordinates it at no cost to you. The only situation where money comes in is if you choose to instruct a specialist solicitor or CHC consultant to represent you, which some families opt for. That's a personal decision, not a requirement; plenty of families represent themselves successfully with free guidance from Beacon CHC, Age UK, or Citizens Advice. Be cautious of any company suggesting you must pay to be taken seriously at an IRP. You don't.

Can I submit new evidence at the Independent Review Panel stage?

You should submit your evidence when you request the IRP, and you'll be invited to make written submissions before the hearing, so the earlier and more complete, the better. NHS England may not accept significant new submissions late in the process, which is why it's important not to hold anything back. That said, the IRP is reviewing the original decision and the evidence that was available, so the strongest approach is usually to show how evidence that already existed was overlooked or misinterpreted, rather than introducing brand-new material. If genuinely new information has come to light, for example, records that were never requested, flag it as early as possible.

What's the difference between the IRP and the Ombudsman?

They're two different stages, and the order matters. The Independent Review Panel is part of the NHS Continuing Healthcare process itself; it reviews whether the person was eligible and whether the ICB followed the correct procedure. The Parliamentary and Health Service Ombudsman (PHSO) sits outside the NHS process entirely and only becomes available after you've been through the IRP. The Ombudsman doesn't re-run the eligibility assessment; instead, it investigates whether there was maladministration or service failure in how your case was handled. In short, the IRP is your last chance to win on the care-needs argument; the Ombudsman is about holding the system to account for how it treated you.