Pharmacy application refused — the appeals process explained
What happens when a pharmacy application decision is challenged — and what your options are at each stage.
Who can appeal?
Both applicants and certain interested parties — typically existing contractors whose representations were unsuccessful — have the right to appeal certain market entry decisions. The right to appeal is not unlimited: it depends on the type of decision made and whether the appealing party made the correct representations at the ICB stage. This is why it is critical to engage correctly at the initial representation stage.
Where appeals go
Appeals against ICB decisions on pharmacy applications in England go to NHS Resolution's Primary Care Appeals service (PCAS). PCAS is independent of the ICB and conducts a fresh consideration of the application.
The appeal timeline
An appeal must typically be lodged within 30 days of the ICB decision. Once lodged, PCAS circulates the appeal to interested parties who have 30 days to submit representations. After a further short period for final comments, PCAS either decides on the papers or arranges an oral hearing.
Oral hearings
Where PCAS considers that an oral hearing is necessary — or where one is requested — a panel is convened. The panel considers written and oral evidence from all parties. Representation at oral hearings by an experienced consultant can significantly affect the outcome.
After the appeal
NHS Resolution's decision is final in most respects. If NHS Resolution has made a legal error or acted unfairly, it may be possible to apply to the High Court for judicial review — but this is a specialist legal process and should be discussed with a lawyer. For most applicants, NHS Resolution's decision is the end of the road.
Wales
The appeals process in Wales follows a different route under the Welsh pharmaceutical regulations, with appeals considered by the relevant local health board or NHS Wales body. Specialist advice on Welsh appeals is important.
Frequently asked questions
In England, both applicants and certain interested parties — typically existing contractors who made correct and timely representations at the ICB stage — have the right to appeal certain market entry decisions to NHS Resolution's Primary Care Appeals service. The right to appeal is not unlimited: it depends on the type of decision and whether the appealing party participated correctly in the representation period. This is one of the most important reasons to engage at the earliest stage of any application that affects your business.
The 30-day period for lodging an appeal to NHS Resolution typically runs from the date of the ICB's written decision. The date of the decision letter — not the date you receive it — is generally the starting point. If you are close to the deadline, contact TI Pharmacy Consultancy immediately. Late appeals are rarely accepted.
NHS Resolution's Primary Care Appeals service conducts a fresh consideration of the application — it is not a review of whether the ICB made a procedural error. PCAS looks at the application afresh against the regulatory criteria, taking into account all the evidence submitted by the parties. This means a well-prepared appeal can succeed even if the ICB's original reasoning appeared sound.
The timeline depends on whether the appeal is decided on the papers or proceeds to an oral hearing, and on PCAS's current caseload. A paper-based appeal may be decided within a few months of submission. An oral hearing appeal can take longer. TI Pharmacy Consultancy advises on realistic timelines at the outset of any appeal.
Judicial review of an NHS Resolution decision is available in limited circumstances — where PCAS has made a legal error, acted outside its powers or failed to follow a fair process. It is not an opportunity to re-argue the merits of the application. Judicial review is a specialist legal process and should be discussed with a lawyer. TI Pharmacy Consultancy can advise on whether the grounds for judicial review appear to exist and can coordinate with legal advisers where appropriate.
Need professional advice?
The information above is for general awareness only. For advice specific to your situation, contact TI Pharmacy Consultancy for a free initial discussion.
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