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. Mental Capacity Act 2005, c. 9. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents
3. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
4. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
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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 where NHS Continuing Healthcare and adult safeguarding intersect. It covers when an inadequate care package becomes a safeguarding matter, the effect of funding disputes on a person's safety, provider concerns and placement breakdown, self-neglect, how safeguarding evidence is used in an assessment, and how the two processes should run alongside one another.
NHS Continuing Healthcare and safeguarding
Safeguarding and NHS Continuing Healthcare are separate processes that regularly involve the same person and the same facts. Where a funding dispute is leaving someone without adequate care, both are engaged.
When an inadequate package becomes safeguarding
Where a person's assessed needs are not being met and they are at risk of harm as a result, that engages adult safeguarding under the Care Act 2014 regardless of which body is funding. A dispute between an Integrated Care Board and a local authority about responsibility does not suspend either body's duty to protect the person from harm.
Funding disputes that cause harm
Where a package has been reduced, withdrawn or never commissioned, and the person is being left without necessary care, that should be raised as a safeguarding concern rather than pursued only as a funding matter. The two run on different timescales, and safeguarding moves faster. Raise both, and say in writing that you are doing so.
Provider concerns and placement breakdown
Where a provider cannot meet a person's needs safely, that may be both a safeguarding matter and evidence of the level of need. A placement breaking down because the person's needs exceed what the setting can provide is directly relevant to the intensity and complexity analysis in a continuing healthcare assessment.
Self-neglect
Where a person with capacity declines care they need, that raises difficult questions that sit at the intersection of safeguarding, capacity and funding. It does not remove the entitlement to an assessment, and refusal of some care does not indicate absence of need. The assessment should record what the person requires, including what they decline and the consequences.
Using safeguarding material as evidence
Safeguarding enquiry records, provider concerns, incident investigations and any resulting protection plan describe risk and the measures required to manage it. That material speaks directly to intensity, complexity and unpredictability, and it is rarely in an assessment bundle unless someone puts it there. Request it and submit it.
Running both processes
They should proceed in parallel rather than one waiting on the other. Safeguarding addresses immediate risk. The continuing healthcare process addresses who funds the care going forward. A body suggesting that a funding question must be resolved before safety is addressed has the sequence wrong, and that is worth saying plainly in writing.
Key takeaway
Where a funding dispute is leaving someone without adequate care, raise safeguarding as well, because it moves faster and addresses immediate risk. Safeguarding records are strong evidence of intensity and complexity, and the two processes should run in parallel.
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Frequently asked questions
Is an unmet care need a safeguarding matter?
It can be, where the person is at risk of harm because assessed needs are not being met. A dispute about which body is responsible does not suspend either body's duty to protect them.
Should we raise safeguarding during a funding dispute?
Where the person is being left without necessary care, yes, alongside the funding challenge. Safeguarding addresses immediate risk and moves faster, so raise both and confirm in writing that you have.
Can safeguarding records support a CHC case?
Yes, and they are frequently absent from bundles. Enquiry records, provider concerns and protection plans describe risk and the measures needed, which speaks to intensity, complexity and unpredictability.
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.