Retrospective reviews and appeals

As a leading provider of retrospective reviews and appeals, our service delivery model is flexible to provide any additional support you might need.

With a team of multi-disciplinary experts aligned with the National Framework for NHS Continuing Healthcare and latest guidance, we bring a depth of knowledge and experience that guarantees quality with a diligent and sensitive approach

Our retrospective reviews and appeals solutions

Xyla stands as one of the largest service providers of retrospective reviews and appeals in the UK, boasting a longstanding history and extensive service provision.

Our approach provides timely high quality administrative and clinical support in the completion of retrospective reviews/appeals within agreed timeframes.

Appeals management

Xyla provides an expert service in the management of the local resolution process. The team facilitating our appeals process have extensive knowledge and experience in continuing healthcare. Utilising a robust triage process and efficient administrative support our team can complete both informal and formal resolution meetings, working with ICBs to meet local policy requirements.

Retrospective reviews

Xyla is a trusted partner delivering retrospective reviews across a number of integrated care boards (ICBs) nationally. Acting as the central point of contact, our team undertake a thorough process contacting all relevant parties and requesting records for the agreed review period. Upon receiving records and completing a care needs portrayal, the outcome of the review will be recorded, quality assured, and submitted to the ICB for verification.

How our retrospective reviews and appeals solutions work

Retrospective reviews

  1. Initial triage: A senior clinician conducts a preliminary assessment of the case to determine if it’s suitable for retrospective review.
  2. Full case triage: Upon receiving consent, application, and legal authority, a comprehensive assessment is carried out, and necessary records are requested.
  3. Gathering and review of records: The CHC Retrospective Review team becomes the central contact point, arranging the review with the applicant/representative. Relevant records are gathered from various sources like care providers, GPs, social services, acute hospitals, and any specialist services identified to be involved.
    Once all records are received, a Care Needs Portrayal (CNP) for the period under review will be produced using all the sourced records available. The CNP is shared with the applicant/representative, who can provide comments or additional evidence. A remote meeting option is available if preferred.
  4. Review and outcome: The checklist is then applied, leading to 3 potential outcomes: Negative checklist, decision support tool (DST) for full review period, split period- part negative checklist/DST. A negative checklist will provide full summaries of the evidence from the CNP, and it will cover the full period of the retrospective review which has been screened out while a DST is completed for periods identified to be a positive checklist. The DST will provide recommended levels of need on each domain, family comments, assessors summary, rationales for levels of need, four key characteristics and an overall Multi-Disciplinary Team (MDT) recommendation. The case undergoes internal quality checks before submission to the ICB for verification, and if agreed, outcome letters are issued.

Why choose Xyla to assist with retrospective reviews and appeals?

  • Conducted retrospective reviews for over 20 Integrated Care Boards (ICBs). 
  • Currently collaborating with several ICBs nationwide on retrospective reviews and appeals. 
  • Over 98% of cases accepted on the first submission. 
  • An established team of professionals, including clinicians with extensive expertise in Continuing healthcare.
  • In the last year we have worked on 14 stage 1 appeals, 133 stage 2 appeals, and 138 retrospective reviews
  • As a trusted strategic partner, we provide insight and recommendation

Contact our reviews and appeals team

If you would like to understand how we can support you with Retrospective reviews and appeals, please get in touch today with our expert team. Combining efficiency, expertise, and compliance, we can support you providing a quality assured service in the delivery of NHS continuing healthcare.

Fill in our enquiry form below or contact us on 0161 238 7485.

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