By Through my work at Care Campaign for the Vulnerable, I am increasingly hearing from families who are struggling with the frequency and impact of Continuing Healthcare (CHC) reviews.
This is not about avoiding scrutiny. Families understand the importance of oversight. But what they are questioning is whether the process, at times, is losing sight of the person at its centre.
Many of the individuals I am asked to support are living with highly complex, unstable and progressive conditions. Their health journeys are not linear. They are marked by repeated hospital admissions, clinical interventions, and ongoing decline. In these situations, time becomes incredibly precious, not just in a practical sense, but emotionally for families trying to hold on to meaningful moments.
Against this backdrop, I am seeing cases where families are asked to attend repeated CHC reviews within short timeframes, despite there being no evidence of improvement. In some instances, the very professionals involved, including GPs, senior nurses and specialist clinicians, have already confirmed that the current care package is appropriate and necessary.
Families describe long, emotionally draining meetings, often lasting several hours, where they are required to revisit the most distressing aspects of their loved one’s condition. When this happens repeatedly without any material change, it can feel less like a safeguard and more like a process for the sake of process.
What concerns me most is when focus shifts away from risk and stability.
I have supported families where changes to care packages ,sometimes based on incomplete or inaccurate information, have led to avoidable harm. These are not abstract concerns. They are real situations where vulnerable individuals have been placed at risk because the full picture was not properly understood.
In these circumstances, consistency of care is not a luxury — it is essential.
Of course, many professionals involved in CHC reviews are committed and diligent in their roles. But the system itself must allow for a more proportionate approach.
Where a person’s condition is clearly complex, deteriorating and unlikely to improve, it is reasonable to question whether three-monthly reviews are always appropriate. More frequent reviews do not necessarily lead to better outcomes, and in some cases, they may place additional strain on families who are already navigating immense emotional and physical pressure.
What I am hearing from families is not a call for less oversight, but for better judgement.
They want a system that listens to clinical consensus, that recognises when needs are stable in their intensity, and that allows space for care to be delivered without constant disruption.
Above all, they want to feel that their voice and the reality of their loved one’s condition – is being heard.
There is an opportunity here for reflection.
To ensure that CHC reviews remain purposeful, proportionate and genuinely centred on the individual – not just the framework that surrounds them.
Because behind every review is a person, and behind every person is a family doing their very best in incredibly difficult circumstances.
