Author and Publication
Author: Ben Slater, Registered Social Worker, Founder and Managing Director of Nellie Supports
Reviewed by: Kerry Slater, Director of Operations
Last reviewed: 20 July 2026
Citation
1. Department of Health and Social Care (2022) National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Available at: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
2. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
3. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
4. Mental Capacity Act 2005, c. 9. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
This article is made available for general information, education and professional reference. It may be downloaded, printed and shared for non-commercial purposes, provided that it is reproduced in full, is not altered in any way, and is properly cited as the work of Nellie Supports Ltd. This material must not be edited, adapted, sold, republished, incorporated into commercial products, or used for commercial training, assessment, report-writing or advisory services without prior written permission from Nellie Supports Ltd.
This article does not constitute legal advice, clinical advice or a substitute for a decision-specific professional assessment. Where legislation, government guidance, court forms or external professional materials are referred to, those materials remain subject to their own copyright, licensing and re-use terms.
Abstract
This guide explains how NHS Continuing Healthcare interacts with hospital discharge. It covers why assessments are often deferred until after discharge, the pressure families face to make rapid placement decisions, the risk of committing to private funding before eligibility is considered, how to protect the position in writing, discharge to assess arrangements, and what to do when a Checklist is completed on the ward.
CHC assessment and hospital discharge
Hospital discharge is where most NHS Continuing Healthcare problems begin. Families are asked to make placement and funding decisions within days, often while the person is still unwell, and frequently before anyone has mentioned that NHS funding might apply.
Why discharge creates the problem
Discharge planning moves quickly and is driven by the need for the bed. Families are asked to choose a home, sign a contract and often start paying, all within a very short period. NHS Continuing Healthcare, by contrast, takes weeks. The two timescales do not fit together, and the result is that funding decisions get made before the eligibility question has been asked.
Assessing in hospital is usually a poor idea
The National Framework recognises that assessing during an acute admission can misrepresent needs, in both directions. A person may be far more dependent than they will be once recovered, or may be masked by the ward environment. Deferring until needs have settled is legitimate and often produces a more accurate assessment.
The deferral becomes the problem
The difficulty is not deferral itself but deferral without a date. An assessment postponed until the person settles can drift for months while they fund care privately. Ask for the deferral, the reason and the intended assessment date to be recorded in writing at the point of discharge. That single step prevents most of the difficulty that follows.
Do not let funding be settled by default
Signing a private contract does not remove any right to NHS Continuing Healthcare, but it does make the position harder to unpick later. If you are being asked to fund privately while the question is open, write to the discharge team and the Integrated Care Board stating that payment is being made pending an assessment. That creates the record needed for any later reimbursement.
Checklists completed on the ward
Many Checklists are completed during discharge planning by staff who have known the person a few days and may not have care records. That produces inaccuracy in both directions. If a Checklist is being completed, provide a short written summary of the person's needs before it is finalised, and ask for a copy of the completed document.
Discharge to assess
Many areas use discharge to assess arrangements, under which a person leaves hospital with a short period of funded support while their longer term needs are assessed. That funding is not NHS Continuing Healthcare and is time limited. Ask what happens at the end of the period and whether a Checklist will be completed before it expires, since that transition is where charges often begin.
Key takeaway
Ask for a Checklist before discharge or a recorded deferral with a date. Put in writing that any private payment is made pending assessment. Provide a written summary before any ward Checklist is finalised, and find out what happens when discharge to assess funding ends.
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Frequently asked questions
Should a CHC assessment happen in hospital?
Often it is better deferred, since assessing during acute illness can misrepresent needs. What matters is that the deferral, the reason and the intended assessment date are recorded in writing rather than left open.
Can we be made to pay while waiting?
Care must continue and payment may be required in the interim, but state in writing that it is made pending assessment. That record supports reimbursement if the person is later found eligible.
Does signing a care home contract affect our rights?
It does not remove the right to an assessment, but it makes the position harder to unpick later. Put the funding position in writing before signing wherever possible.
Related NHS Continuing Healthcare pages
These links take you to the most relevant Nellie Supports service page and to the supporting guides that explain the surrounding process.
Speak to an independent CHC specialist
Nellie Supports prepares independent needs evidence for NHS Continuing Healthcare assessments, reviews and appeals across England and Wales. Our reports are written by registered social workers on a permanent employed team, with internal peer review before release. Call 0333 987 5118 or send an enquiry and we will talk through where you are in the process.