National appeals process

Who can make an appeal?

In general terms appeals are made by persons dissatisfied with the decision on their eligibility applications for relevant schemes, or by a person or service representing them. In some instances, consent from the applicant may be required where a third party seeks to represent them.

You must be in receipt of a decision letter from a HSE service in order to make an appeal

How do I appeal?

It is necessary to clearly set out the grounds for your appeal in:

  • A letter which may be sent to the National Appeals Service, HSE, Ballyshannon Health Campus, An Clochar, College Street, Ballyshannon, Co Donegal.
  • An email which may be sent using the address nationalappeals@hse.ie

What should be contained in my appeal?

When appealing against a decision made in relation to your eligibility for a scheme/service, you should provide:

  • full contact details
  • full information in relation to the decision being appealed, ie decision issued when/by whom, and include relevant client ID/reference numbers
  • you should set out your case fully and provide grounds for your appeal in the context of the decision which has been issued to you. In effect, the basis on which you believe that this decision is incorrect in line with relevant legislation/regulations/guidelines related to the scheme

If you are unsure how to do this, you should seek help from a HSE Staff member or from other relevant individuals or bodies which may be able to provide advice/assistance.

Timelines

  • If you wish to appeal a decision made on an application under the Nursing Homes Support Scheme – ‘Fair Deal scheme’, you have no later than 40 working days after notice of the decision was given. This is a statutory requirement under the Nursing Homes Support Scheme Act 2009( as amended).
  • In many instances, the decision letter from the local office will indicate the time period for making an appeal. For most schemes, you have 21 days from the date of the decision in order to lodge the appeal.
  • The Appeals Service Manager may extend the time limit for initiating an appeal where, in circumstances of a particular case, it is deemed reasonable to do so.

General Outline of Appeal Process

In some instances, it may be possible to resolve the issue identified without the need for an appeal decision to be made by an Appeals Officer. This is particularly relevant where a reassessment/review process may be more appropriate. We will communicate with you in this regard.

Once your issue is identified as requiring a decision by an Appeals Officer, the following process is followed:

  • your appeal will be recorded and acknowledged to you
  • the Appeals Service will send a copy of your appeal to the relevant HSE section and request your file. If your correspondence also refers to a complaint about actions of the HSE, this may be forwarded for the attention of the appropriate HSE section
  • the local HSE section will forward the file to the Appeals Service for further processing of the appeal
  • in some circumstances a local review may form part of the appeals process
  • before a decision is made on your appeal an Appeals Officer will consider fully all of the available relevant information (when necessary we may request additional information)
  • you will be notified in writing of the Appeals Officer’s decision
  • a copy of the appeal decision will be sent to the local HSE section for any required action

The Appeals Service will make a decision on your appeal as quickly as possible and in general terms will do so in a matter of weeks.  A small number of appeals may take longer depending on their level of complexity.

Other Information about the appeals process

  • We will try to address, in so far as is possible, any special needs/circumstances of individuals.
  • If you do not receive an acknowledgement letter you should contact the Appeals Office directly.
  • The National Appeals Service is free of any charge.
  • All personal data processed by the National Appeals Office will take place in accordance with General Data Protection Regulation (GDPR) and will only be used for the purposes connected to the functions of this Office. Please click here for more information.

General Information on Complaints process

It is your right as a service user of the HSE to make a complaint if you believe that standards of care, treatment or practice fall short of what is acceptable. 

Full details of the HSE - Complaints Service, including information on the process is available at the website www.hse.ie, as is a full list of complaints officers and their contact details. 

You may also complain directly to yoursay@hse.ie

Anyone who is dissatisfied with an administrative action of the Health Service Executive may make a complaint to the Office of the Ombudsman, 18 Lower Leeson Street, Dublin 2,

Phone: 01 639 5600 

Lo-call: 1890 22 30 30

www.ombudsman.gov.ie