Appealing a CQC decision to the First-tier Tribunal

The First-tier Tribunal is the independent body that considers appeals against certain CQC enforcement decisions. It sits within the Health, Education and Social Care Chamber and is often still referred to as the Care Standards Tribunal. For a provider facing cancellation, suspension, unwelcome conditions or refusal of registration, it is the route to an independent decision, and the way an appeal is prepared can make a real difference to the outcome.

Our Health and Social Care team regularly support providers with the appeal process. They know how the Tribunal approaches proportionality and risk, and how to use that understanding to achieve the right result, whether at a Tribunal hearing or by agreement with CQC.

What can be appealed

There is no appeal to the Tribunal against a Warning Notice or against an inspection rating. Those are dealt with through CQC’s representations, factual accuracy and rating review processes.

Section 32 of the Health and Social Care Act 2008 gives a right of appeal to the Tribunal against:

A Notice of Decision, including decisions to cancel or suspend a registration, to impose, vary or remove conditions, or to refuse an application.
A notice served under the urgent procedure in section 31 (e.g. suspension or variation, removal or imposition of conditions of registration), which takes effect immediately.
An order made by a justice of the peace under section 30 which relates to the urgent cancellation of registration.

Time limits and how to appeal

An appeal must be lodged with the Tribunal in writing within 28 calendar days of service of the Notice of Decision or the urgent order.

If the decision was reached through the ‘normal’ Notice of Proposal route, lodging the appeal means the decision does not take effect until the appeal is determined or withdrawn, and the provider can continue to operate. If CQC used its urgent powers, the decision takes effect immediately and remains in force unless and until the Tribunal directs otherwise. Appeals against CQC’s urgent powers are dealt with on an expedited basis in line with the memorandum of understanding between CQC and the Tribunal service.

How the Tribunal approaches an appeal

The Tribunal hears the case afresh. It is not limited to reviewing whether CQC acted reasonably at the time; it decides for itself, on the evidence, whether the action is justified. Critically, it considers the position at the date of the hearing. For example, in Westhope Limited v Care Quality Commission (2025) the Tribunal confirmed that material improvement since CQC’s decision can make enforcement action disproportionate even where the service has not reached full compliance or a good rating, and it emphasised CQC’s duty under section 4(1)(e) of the Act to act proportionately to the risks involved.

That has two practical consequences. A provider that uses the months between the decision and the hearing to improve, evidence that improvement and invite re-inspection puts itself in a much stronger position. And CQC, faced with that evidence, frequently reconsiders its position. Our team regularly settle Tribunal appeals on behalf of our clients without the need for a final hearing. However, every case is fact specific.

The appeal process

Once the appeal is accepted by the Tribunal, CQC is given a set amount of time to respond (20 working days for a ‘normal’ appeal and three working days under the expedited process). If CQC opposes the appeal, the Tribunal will direct for parties to put forward a proposed timetable. A telephone case management hearing will usually take place to agree the timetable and discuss any other relevant matters. Parties will then proceed to follow the timetable which will include steps such as exchanging witness statements and evidence, producing a bundle, putting forward a schedule of issues (referred to as a Scott Schedule) and filing skeleton arguments. Any final hearing will usually take place at a suitable venue close to the appellant.

The Tribunal

The Tribunal has the power to confirm CQC’s decision or direct that it has no effect (or, in relation to urgent enforcement action, direct that a decision ceases to have effect). It can also vary or remove conditions, impose conditions of its own and change the length of a suspension. Either party can seek permission to appeal to the Upper Tribunal on a point of law, and this can be escalated to the Court of Appeal if necessary.

Frequently asked questions

How long does an appeal take?

Timescales partly depend on the Tribunal’s availability and the complexity of the matter. Non-urgent appeals commonly take several months to reach a final hearing. Urgent matters under the expedited appeals process are usually concluded within 3-5 weeks of the appeal being submitted. Many appeals are resolved by agreement before a hearing and parties may agree to a pause in proceedings (referred to as a ‘stay’) to allow certain specific steps to take place, for example to give CQC time to reinspect a service and produce a report.

Who pays the costs?

The general rule in the Tribunal is that each party bears its own costs. The Tribunal has a power to award costs where a party has acted unreasonably in bringing, defending or conducting the proceedings, but such orders are the exception.

Can we settle with CQC during the appeal?

Yes, and it is common. Where a provider can demonstrate sufficient sustained improvement or that it can comply with the regulations in registration appeals, CQC may agree to withdraw its opposition to the appeal which can include substituting conditions of registration. Any agreement is recorded in a draft Order and the appeal is then determined by consent with the Tribunal’s approval.

Does the Tribunal consider our current rating?

It considers the current position of the service as a whole, including the most recent inspection findings, but a rating of inadequate or requires improvement does not by itself mean an appeal will fail. The question is whether the action remains proportionate to the risk at the date of the hearing. Enforcement must be based on breaches of statutory requirements, not ratings.

How we support providers

We can advise on prospects of success before an appeal is lodged, prepare and file the appeal, assemble the evidence including witness statements and reports from independent consultants and clinical input where needed, and represent providers at case management and final hearings. Throughout the process, we maintain an open channel of communication with CQC’s legal team so that a negotiated outcome may be agreed where that serves the client best.

Our health and social care team

Our specialist health and social care team is led by Neil Grant, who has more than 30 years’ experience in the sector, including acting for regulators. The team acts for care homes, domiciliary care agencies, supported living providers, GP practices, dental practices, independent hospitals and clinics across England. They also act for providers registered with other regulators such as Ofsted and CIW.

If you require advice on any aspect of CQC enforcement, please contact Neil Grant or Samantha Burges on 01483 451 900.