Recovering Historic Costs
Retrospective CHC Claims
If your loved one paid privately for care \u2014 or has died after paying privately \u2014 and their needs at the time would have met the CHC threshold, the NHS may owe your family money. The retrospective review process exists specifically for this. It is underused, poorly publicised, and frequently mishandled by ICBs.
What is a retrospective CHC claim?
A retrospective claim \u2014 formally called a Previously Unassessed Period of Care (PUPoC) review \u2014 is a request for the NHS to assess whether a person should have received CHC funding during a period in the past when they were paying privately.
PUPoC reviews can cover periods of care in nursing homes, residential care homes, or at home. They can be requested by the person themselves if still alive, or by their family after death. There is no upper time limit in law, though ICBs sometimes try to apply one \u2014 this is not legally correct.
The DHSC published updated PUPoC guidance in March 2025. ICBs are required to follow it.
Who can make a claim?
You can request a PUPoC review if:
- Your loved one is currently paying privately for care and was never offered a CHC assessment
- Your loved one was assessed and refused, but you believe the decision was wrong for the period in question
- Your loved one has died and paid privately during their life \u2014 a claim can be made on behalf of the estate
The claim is against the ICB responsible for the area where care was received. If care was received in more than one area, a claim may be needed against multiple ICBs.
How the PUPoC process works
Step 1\u2014 Submit a written request to the relevant ICB, identifying the period of care you want reviewed and why you believe CHC should have been funded. Include the person's name, NHS number, dates of care, and care provider.
Step 2 \u2014 The ICB appoints a multidisciplinary team to carry out a retrospective assessment. Unlike a prospective assessment, this is done using historical records \u2014 GP notes, care home records, hospital discharge summaries, and family evidence.
Step 3\u2014 The MDT completes a Decision Support Tool based on the historical evidence. The standard is what the person's needs were at the time, not their needs today.
Step 4\u2014 The ICB makes a decision. If eligibility is found, the ICB funds the care from the start of the eligible period. Care home fees paid during that period are reimbursed, minus a deduction for “hotel costs” (food, accommodation) \u2014 which the person would have paid regardless.
Step 5 \u2014 If refused, the same appeals process applies: local resolution, then IRP.
What evidence do you need?
Historical records are the foundation. For a period of care that may have been years ago, you need to reconstruct the person's needs as they were at the time.
Request all of the following:
GP records \u2014 the complete primary care record for the period. You are entitled to these under UK GDPR whether the person is alive or deceased (if you are the executor or next of kin).
Care home or agency records \u2014 daily care logs, incident reports, medication administration records. Request these in writing from the care provider. They are legally required to retain records for a minimum period.
Hospital records \u2014 discharge summaries, consultant letters, specialist assessments. These often contain the clearest clinical picture of needs at a specific point in time.
Family records \u2014 your own diaries, letters, or notes from the period. Any contemporaneous record of the person's needs and behaviour is valuable evidence.
The stronger the historical record, the stronger the claim. ICBs sometimes try to refuse PUPoC reviews on the grounds that records no longer exist \u2014 this is not a lawful basis for refusal if some records remain.
Should you use a solicitor?
You can make a PUPoC claim yourself. The process is administrative rather than legal, and ICBs are required to handle it correctly whether or not you have representation.
In practice, solicitors who specialise in CHC retrospective claims add significant value. They know what evidence to request, how to frame domain scoring arguments, and how to challenge ICBs that attempt to obstruct or delay the process. Most work on a no-win no-fee basis for retrospective claims \u2014 they take a percentage of the recovery.
Our platform connects families with specialist CHC solicitors for retrospective claims. Use the eligibility check to get a clear picture of whether a claim is worth pursuing before committing to representation.
Frequently asked questions
Is there a time limit on retrospective claims?
There is no statutory time limit in law. ICBs sometimes impose their own limits, but these are not legally binding and have been successfully challenged. The practical constraint is evidence availability — the further back the claim, the harder it becomes to reconstruct needs from records. Claims going back 10–15 years are not uncommon.
What happens if the person has died?
A PUPoC review can be requested on behalf of the estate after death. The executor or administrator of the estate, or a next of kin, can submit the request. Any recovery is paid to the estate and distributed according to the will or intestacy rules.
How long does a retrospective review take?
ICBs are supposed to complete PUPoC reviews within 6 months. In practice many take longer. If an ICB is not progressing your claim within a reasonable timeframe, write formally setting a deadline and referencing the DHSC PUPoC guidance (March 2025). If it still fails to act, raise a formal complaint.