NHS Continuing Healthcare (CHC) is a fully funded package of care arranged and paid for by the NHS for people who have significant ongoing health needs. Unlike many social care services, NHS continuing healthcare is not means-tested, meaning eligibility is based on health needs rather than income or savings.
For people with complex medical conditions, disabilities or severe long-term health problems, CHC funding can cover the full cost of care, whether the support is provided at home, in a care home or in another setting.
This guide explains what NHS continuing healthcare is, who may qualify for CHC funding, how the assessment process works and what happens after a decision is made.
What Is NHS Continuing Healthcare (CHC)?
NHS Continuing Healthcare (CHC) is a package of care arranged and funded entirely by the NHS for individuals who are assessed as having a primary health need. This means that the main reason for their care relates to health needs rather than social care needs.
If a person qualifies for NHS continuing healthcare, the NHS will pay for the full cost of their care.
This can include:
- nursing care
- personal care such as washing, dressing and mobility assistance
- medical treatment and monitoring
- specialist equipment
- care home accommodation if required
If care is provided in a care home, the NHS will cover the care home fees. If care is delivered at home, the NHS funds the care and support needed to meet the person's assessed health needs.
Who Is Responsible for NHS Continuing Healthcare?
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NHS continuing healthcare is organised by local Integrated Care Boards (ICBs). These bodies are responsible for assessing eligibility and arranging funding for care packages.
The decision to grant CHC funding is based on the level and complexity of a person's health needs rather than on their financial situation or specific medical diagnosis.
Who Can Get NHS Continuing Healthcare?
To qualify for NHS continuing healthcare, a person must be assessed as having significant ongoing physical or mental health needs.
The key factor is whether the majority of the care required is related to managing health conditions rather than supporting everyday living needs.
Eligibility may apply to people who:
- have complex or severe medical conditions
- require continuous nursing supervision
- have rapidly deteriorating health
- require intensive medical care and monitoring
It is important to note that having a particular condition, such as dementia or Parkinson’s disease, does not automatically qualify someone for CHC funding. The decision depends on the overall level and type of care required.
How to Apply for NHS Continuing Healthcare
If you believe you or someone you care for may qualify for NHS continuing healthcare, the first step is to speak to a healthcare professional.
You can contact:
- a GP or hospital doctor
- a nurse
- a social worker
- your local Integrated Care Board (ICB)
They can arrange for an initial assessment to determine whether a full CHC assessment is required.
How the CHC Assessment Process Works
The NHS uses a structured process to assess whether someone qualifies for continuing healthcare funding. This process involves several stages and multiple healthcare professionals.
1. Initial Consideration
Healthcare professionals may suggest an assessment if they believe a person has significant health needs. This may happen:
- after a hospital stay when recovery is unlikely
- during a care needs review
- when someone's health deteriorates significantly
- before moving into a nursing home
- during an annual nursing care review
In cases where a person's condition is rapidly deteriorating and they may be approaching the end of life, a fast-track assessment may be used to provide urgent funding.
2. The CHC Checklist Assessment
The assessment process usually begins with a screening tool called the CHC Checklist. This is completed by a trained nurse or social worker.
The checklist determines whether the person should move forward to a full NHS continuing healthcare assessment.
If the checklist indicates that further assessment is necessary, the case proceeds to the next stage.
3. Full Assessment and Evidence Gathering
If the checklist threshold is met, healthcare professionals collect evidence about the person's needs. This includes information about physical health, mental health, mobility, behaviour and daily care requirements.
Medical records, care plans and professional assessments are all considered during this stage.
4. Decision Support Tool (DST) Meeting
A multidisciplinary team of health and social care professionals reviews the evidence and completes the Decision Support Tool (DST). This document helps determine whether the individual has a primary health need.
The individual being assessed, or their representative, can attend this meeting and share their views.
5. Final Decision by the Integrated Care Board
The recommendation made by the assessment team is submitted to the Integrated Care Board responsible for funding care.
In most cases, the ICB accepts the recommendation and confirms the final decision.
The decision and explanation are then sent to the individual in writing.
How Long Does the CHC Assessment Process Take?
The NHS aims to complete the continuing healthcare assessment process within 28 days from the initial checklist assessment.
However, in practice, the process can sometimes take longer depending on the complexity of the case and the availability of information required for the assessment.
What Happens If You Are Eligible for CHC Funding?
If a person is found eligible for NHS continuing healthcare, the NHS will arrange and fund a care package that meets their needs.
This care may be provided:
- in the person's own home
- in a residential care home
- in a nursing home
- in another healthcare setting
| Type of Care Setting | What NHS CHC Funding Covers |
|---|---|
| Care at home | Personal care, nursing care, support workers and medical equipment. |
| Residential care home | Full care home fees including accommodation and care services. |
| Nursing home | Nursing care, personal care and accommodation. |
| Specialist care setting | Complex healthcare support and medical supervision. |
The care plan will normally be reviewed after three months and then at least once a year to ensure it still meets the person's needs.
Personal Health Budget
People receiving NHS continuing healthcare may request a Personal Health Budget. This allows individuals to have more control over how their care is arranged.
However, this budget cannot usually be used to pay for care home accommodation.
What Happens If You Are Not Eligible for CHC?
If someone is not eligible for NHS continuing healthcare funding, there are still other support options available.
Appealing the Decision
If you disagree with the CHC decision, you have the right to challenge it.
You can request that the Integrated Care Board reconsider the case. If the issue is not resolved, it may be possible to request an independent review through the NHS complaints system.
Local Authority Support
If CHC funding is refused, the individual may be referred to the local authority for a social care assessment. The local council will evaluate care needs and determine whether financial support is available.
This support is usually means-tested, meaning the individual may need to contribute towards their care costs depending on their income and assets.
NHS-Funded Nursing Care
If a person does not qualify for full CHC funding but requires nursing care in a nursing home, they may still receive NHS-funded nursing care.
This is a fixed contribution paid by the NHS to the nursing home to support the cost of registered nursing care.
This funding does not cover accommodation costs, but it helps reduce the overall care home fees.
Joint Health and Social Care Packages
In some cases, the NHS and the local authority may jointly fund a care package. This happens when a person has both health and social care needs.
In these situations, professionals will determine which organisation is responsible for managing the care plan and reviewing support.
FAQ: NHS Continuing Healthcare (CHC)
What does CHC stand for?
CHC stands for NHS Continuing Healthcare. It is a fully funded care package provided by the NHS for individuals with significant health needs.
Is NHS continuing healthcare means-tested?
No. CHC funding is based on health needs rather than income or savings.
Can someone receive CHC funding at home?
Yes. NHS continuing healthcare can fund care provided in a person's own home if their health needs require this level of support.
How often is CHC funding reviewed?
The care package is usually reviewed after three months and then at least once every year to ensure it still meets the person's needs.
Can you appeal a CHC decision?
Yes. If you disagree with the decision, you can request a review and pursue the case through the NHS complaints and appeals process.
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