NHS Continuing Healthcare, often shortened to NHS CHC, is a package of ongoing care arranged and funded entirely by the NHS for adults with significant health-related needs.
Unlike local-authority social care, NHS CHC is not means-tested. Your income, savings and property should not affect whether you qualify. Eligibility depends on the nature and extent of your care needs and whether those needs amount to what is known as a primary health need.
If you or a loved one requires substantial support because of an illness, disability or accident, it is important to consider whether the NHS should be funding some or all of that care.
FAQs
How do I apply for NHS Continuing Healthcare?
The process usually starts with an NHS Continuing Healthcare Checklist, which helps decide whether a full assessment is needed. This can be requested through a GP, social worker, care home, hospital discharge team or the relevant NHS body. We can help you understand the process and prepare the right evidence before an assessment takes place.
What happens during a NHS CHC assessment?
If a full assessment is needed, a multidisciplinary team will review your loved one’s care needs using the Decision Support Tool. They will consider areas such as mobility, cognition, behaviour, nutrition, continence, medication, skin integrity and other health needs before making a recommendation on eligibility.
What is the difference between NHS Continuing Healthcare and social care funding?
NHS Continuing Healthcare is arranged and funded by the NHS for adults with a primary health need and is not means-tested. Social care funding is usually arranged by the local authority and is financially assessed, meaning savings, income and assets may be taken into account.
I am so pleased that I engaged Emerald Law to investigate the possibility that my aunt should have been eligible for NHS Continuing Healthcare funding. Emerald Law discovered that this was in fact the case, have recovered a substantial amount of care fees and we have at last received our proper inheritance, just as my aunt had intended.
We are very grateful to Emerald Law for their professional advice and the very successful outcome, which has financially helped both families. We would especially like to thank Phil Turner who handled the case.
Who may qualify for NHS CHC?
Absolutely amazing service!! So friendly and so helpful, it was the first time in a long time that I’ve got hope!! And now I know have rights and have a leg to stand on!! I cannot thank Angie enough for her help today.
I have just had some fantastic advice at Emerald Law I would highly recommend them.
Emerald Law, specifically Heather Boyd, have been extremely efficient and professional throughout the process. Any information has been passed on or received in a timely manner and I would recommend Emerald Law without reservation.
All in all great service and a competitive price, no complaints. Always available when needed, thank you Heather and Caitlin, you were excellent!
We are extremely grateful to Emarald Law for the excellent service they provided. They informed us through every step from beginning to end and the app was very useful too.
Clear communication throughout. Would use again.
I am so pleased that I engaged Emerald Law to investigate the possibility that my aunt should have been eligible for NHS Continuing Health Care funding. Emerald Law discovered that this was in fact the case, have recovered a substantial amount of care fees and we have at last received our proper inheritance, just as my aunt had intended.
We are very grateful to Emerald Law for their professional advice and the very successful outcome, which has financially helped both families. We would especially like to thank Phil Turner who handled the case.
What our clients say
Could your loved one be eligible for funding?
Paying privately for residential or nursing care
Complex health conditions such as Dementia, Alzheimer's, Parkinson's or stroke-related illness
Repeated falls, mobility issues or high supervision needs
Complex medication, nutrition or continence needs
Pressure sores or skin integrity concerns
Distressed, challenging or unpredictable behaviour
Refused NHS CHC funding
Never properly assessed for NHS CHC funding
You do not need to know whether your loved one qualifies before speaking to us. That is what we can help you assess.
Not sure if this applies to your loved one?
Understanding eligibility for NHS Continuing Healthcare funding is rarely straightforward. A consultation with our experts will help you know where you stand.
Find out if your loved one could be eligible for NHS CHC funding
Free initial consultation
Full Eligibility & Action Plan meeting for less than a day's care fee
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If your loved one is paying privately for care and has significant health needs, it is worth seeking advice.
Clear action plan with next steps
Can I challenge a past NHS CHC decision?
Yes, in some cases. If your loved one was refused NHS Continuing Healthcare, you may be able to challenge the decision if needs were not properly considered, evidence was missed, or the criteria were not applied correctly. Time limits can apply, so it is important to seek advice promptly.
Can someone receive NHS CHC funding at home?
Yes. NHS Continuing Healthcare can fund care in a person’s own home, as well as in a care home, nursing home or other care setting. Eligibility depends on the person’s assessed health and care needs, not where they receive care.
How can you help with appeals?
We can review the decision, identify potential grounds of challenge, gather supporting evidence and help present your loved one’s needs clearly under the NHS Continuing Healthcare criteria. We can also support you through local resolution and, where appropriate, further review stages.
Can you help recover care fees that were wrongly paid?
Yes, where there may be grounds to argue that your loved one should have been assessed or found eligible for NHS Continuing Healthcare during a past period of care. We can advise on whether a retrospective review may be possible and help prepare the evidence needed to pursue a claim.
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What is NHS Continuing Healthcare funding?
NHS Continuing Healthcare is available to adults aged 18 or over who are assessed as having a primary health need.
There is no definitive list of conditions that automatically qualify someone for funding. A diagnosis of dementia, Parkinson’s disease, multiple sclerosis, motor neurone disease or another serious condition does not, by itself, guarantee eligibility. Equally, a person should not be ruled out simply because they do not have a particular diagnosis.
The assessment must focus on the person’s actual care needs and the skill, frequency and level of intervention required to manage them safely.
Someone may need to be considered for NHS CHC where they experience substantial or difficult-to-manage needs involving areas such as:
- Cognition or communication
- Behaviour
- Mobility
- Nutrition
- Continence
- Skin integrity
- Breathing
- Medication
- Altered states of consciousness
- Psychological or emotional needs
The way these needs interact can be just as important as the severity of any individual need.
NHS Continuing Healthcare explained
NHS Continuing Healthcare is a fully funded package of health and associated social care provided outside hospital.
It may cover care delivered:
- In the person’s own home
- In a residential care home
- In a nursing home
- In another suitable care setting
When someone qualifies, the NHS, through the relevant Integrated Care Board, becomes responsible for arranging and funding the care required to meet their assessed needs. Eligibility does not depend on where the person lives, who provides their support or whether they have a particular diagnosis.
This means someone may qualify even if their care is being provided by relatives, domiciliary carers or staff within a residential setting.
What is a primary health need?
The central question in an NHS CHC assessment is whether the person’s main need for care is a health need rather than a social care need.
Assessors should consider four key characteristics:
Nature
This relates to the type of needs involved, their overall effect on the person and the interventions required to manage them.
Intensity
This considers the quantity, severity and continuity of the care required, including how frequently support or intervention is needed.
Complexity
This looks at how different needs interact and whether specialist knowledge or skill is required to monitor and manage them effectively.
Unpredictability
This considers whether the person’s needs fluctuate, deteriorate unexpectedly or create risks that require timely and skilled intervention.
A person does not have to demonstrate all four characteristics to qualify. The assessment should consider the totality of their needs and whether, taken together, they establish a primary health need.
How is NHS Continuing Healthcare assessed?
For most people, the NHS CHC process involves two stages:
The NHS CHC Checklist
The Checklist is an initial screening tool, usually completed by a health or social care professional.
It considers a range of care domains and helps determine whether the person should proceed to a full assessment. A positive Checklist does not guarantee funding; it means that a more detailed assessment should take place.
The full NHS CHC assessment
Where the Checklist is positive, a multidisciplinary team completes a full assessment using the Decision Support Tool, commonly known as the DST.
The team will gather evidence about the person’s needs, score the relevant care domains and consider their nature, intensity, complexity and unpredictability.
The Integrated Care Board then makes the final eligibility decision.
How Emerald Law can help
Our specialist team can guide you through the NHS Continuing Healthcare process and help ensure the person’s needs are accurately evidenced and properly considered.
We can assist with:
- Initial advice about potential NHS CHC eligibility
- Preparing for the Checklist or full assessment
- Reviewing care and medical evidence
- Attending or supporting assessment meetings
- Reviewing the Decision Support Tool
- Challenging an unsuccessful decision
- Appealing the withdrawal of existing funding
- Requesting retrospective assessments
- Recovering care fees that may have been wrongly paid
We will explain the process clearly, identify the important evidence and advise you on the most appropriate next steps.
NHS CHC is not the same as NHS-funded Nursing Care
NHS Continuing Healthcare and NHS-funded Nursing Care are separate forms of support.
NHS CHC can fund an individual’s complete assessed package of care, including accommodation where appropriate.
NHS-funded Nursing Care is a contribution made by the NHS towards the cost of registered nursing care for eligible people living in a nursing home. It does not ordinarily cover the person’s full accommodation and care-home fees.
A person should usually be considered for NHS Continuing Healthcare before a decision is made about NHS-funded Nursing Care.
Why NHS CHC applications can be difficult
The NHS Continuing Healthcare framework is detailed, evidence-heavy and often difficult for families to navigate alongside the immediate pressures of arranging care.
Common problems can include:
- Needs being described as routine or well-managed
- Insufficient consideration of how needs interact
- Care records failing to capture the full level of support provided
- Assessments focusing too heavily on diagnoses
- Family evidence being overlooked
- Needs being understated because medication or skilled care is currently controlling them
- Confusion between health needs and social care needs
A person’s needs should not be disregarded simply because they are being successfully managed. In many cases, needs are only stable because substantial care, monitoring and intervention are already in place.