Clinical Case Reviewer/Assessor, NHS CHC Appeals Team

NHS Lancashire and South Cumbria Integrated Care Board (125); Preston; On-site; GBP 40,000 - 50,000; Full time

Job summary

A regional healthcare authority is seeking a Clinical Case Reviewer/Assessor to provide clinical expertise for continuing healthcare (CHC) appeals and retrospective reviews. You will meet with patients and their representatives, delivering advice in potentially contentious situations while ensuring adherence to protocols. Essential qualifications include a relevant degree and a strong understanding of the health and social care environment. This role requires excellent analytical and communication skills, offering an engaging opportunity to support patients throughout the appeals process.

Qualifications

• Educated to degree level in a relevant subject or equivalent level of experience working at a similar level.
• Ability to analyse and interpret information for effective decision-making.
• A good understanding of the health and social care environment.

Responsibilities

• Provide clinical expertise for CHC appeals and retrospective reviews.
• Coordinate and chair local resolution and retrospective review meetings.
• Engage with patients and families in contentious situations regarding CHC challenges.

Skills

Clinical expertise in CHC

Strong analytical skills

Effective communication

Knowledge of health and social care

Education

Degree in a relevant subject or equivalent experience

Job description

Clinical Case Reviewer/Assessor, NHS CHC Appeals Team

Closing date: 20 January 2026.

Responsibilities

• Provide clinical expertise for CHC appeals and retrospective reviews.
• Apply the National Framework process robustly within appeals, retrospective reviews and disputes, providing evidence to support CHC eligibility recommendations and decision-making.
• Coordinate and chair local resolution and retrospective review meetings, offering expert clinical advice where patients or families dispute decisions or request back‑dated reviews.
• Meet with patients/representatives in potentially highly contentious situations and deliver responses to complex CHC‑related challenges, via telephone, video call or in person as required.
• Engage meaningfully with patients and the public in CHC appeals and retrospective reviews, including leading the stage 1 clinical call process.
• Ensure patients/families/representatives are supported and aware of the appeal and retrospective review processes governed by the ICB.
• Complete detailed, accurate and efficient reviews of all sourced evidence.
• Provide timely, relevant correspondence to patients/families/representatives, keeping them informed of developments.
• Attend, with the line manager, to present and defend CHC cases at NHS England’s Independent Review Panels on behalf of the ICB.
• Support the line manager to review CHC appeals and retrospective review processes, identifying opportunities to improve pathways and enhance quality and effectiveness.

About us

• Adhere to and uphold the ICB’s vision and values.
• Observe the provisions of and adhere to all ICB policies and procedures.
• Complete ICB Statutory and mandatory training as required and any other training courses relevant to the post.
• Abide by the ICB’s commitment that all staff will be treated with respect by management, colleagues, patients and visitors and will treat management, colleagues, patients and visitors with the same level of respect. Staff will be supported to challenge any discriminatory behaviour that may be based on differences in race, disability, language, culture, religion, sexuality, age, and gender or employment status.
• Adhere to the relevant Code of Practice of relevant professional bodies (if appropriate).
• The post holder must be flexible in the duties performed and is expected to carry out similar duties, not specifically listed above, as required and may be cross‑site.

Person Specification

Experience

• Educated to degree level in a relevant subject or equivalent level of experience working at a similar level in a specialist area.

Knowledge

• A good understanding of the health and social care environment and the roles and responsibilities within it.

Analytical skills

• Ability to analyse and interpret information, pre‑empt and evaluate issues and recommend appropriate courses of action to address them.
• Ability to engender trust and confidence and demonstrate integrity in the provision of advice and support.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and requires a submission for Disclosure to the Disclosure and Barring Service (formerly CRB) to verify any previous criminal convictions.

NHS Lancashire and South Cumbria Integrated Care Board (125)