NHS Continuing Healthcare

NHS Continuing Healthcare (CHC) is a package of care arranged and funded entirely by the NHS for adults whose needs are primarily about health. If someone qualifies, the NHS pays the full cost of their care home, including the accommodation, and there is no means test. It is one of the most valuable and most overlooked forms of help.

Who qualifies

CHC is not about a particular diagnosis. It is about whether someone has a primary health need, meaning the main reason they need care is health-related rather than help with daily living. Someone with advanced dementia, a complex long-term condition, or rapidly changing needs may qualify, while someone who mainly needs help washing and dressing usually will not.

How the assessment works

There are two stages:

• A Checklist, a quick screen a nurse, social worker or doctor can complete to see whether a full assessment is needed.
• A full assessment using the Decision Support Tool, where a multidisciplinary team scores needs across twelve areas such as mobility, cognition, behaviour, drug therapies and breathing. The pattern and intensity of needs decides eligibility, not any single score.

If needs are urgent and deteriorating, a Fast Track tool can put funding in place within days.

CHC, FNC and the difference

If someone does not qualify for full CHC but lives in a nursing home and needs care from a registered nurse, the NHS still pays a flat weekly funded nursing care contribution toward the nursing element. CHC covers everything; funded nursing care covers only the nursing part. You can be assessed for CHC first and fall back to funded nursing care if you do not qualify.

If you disagree with the decision

CHC decisions are often refused at first and overturned on review, so it is worth challenging a ‘no’ if you believe the needs are primarily health-related. You can ask the integrated care board for a review, and there are specialist advisers and solicitors who work on CHC appeals. Keep copies of all assessments and care records.

Where this fits

CHC sits alongside the other routes in how to pay for a care home. If CHC is not awarded, the means test decides what you pay.

England only; other UK nations have their own systems. This is general information, not medical, financial or legal advice.