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. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
3. The Care and Support (Charging and Assessment of Resources) Regulations 2014, SI 2014/2672.
4. Department of Health and Social Care. Care and support statutory guidance. Available at: https://www.gov.uk/government/publications/care-act-statutory-guidance
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Abstract
This guide compares the three principal routes to funding care in England: NHS Continuing Healthcare, NHS-funded Nursing Care and means tested local authority social care. It explains what each covers, how a person qualifies, whether means testing applies, the order in which they should be considered, and how joint packages fit between them.
CHC, Funded Nursing Care and social care compared
Three different routes fund care in England and they are frequently confused with one another. The differences in what they cover, and in what a family pays, are substantial. This guide sets them side by side.
NHS Continuing Healthcare
A package of care arranged and funded solely by the NHS for someone assessed as having a primary health need. It is not means tested. In a care home it covers the full placement cost including accommodation. At home it covers the assessed care package. Qualification is through the Checklist, then a full assessment using the Decision Support Tool, then a decision by the Integrated Care Board.
NHS-funded Nursing Care
A flat rate NHS contribution towards the cost of registered nursing input for someone living in a nursing home who is not eligible for full NHS Continuing Healthcare. It is paid directly to the home rather than to the person, is not means tested, and covers only the nursing element. The rest of the fee remains payable by the person or the local authority.
Local authority social care
Care and support arranged under the Care Act 2014 following a needs assessment. It is means tested, so capital above the threshold set by government means the person pays the full cost, and income is taken into account through a contribution calculation. This is the default route where the person is not eligible for either NHS option.
The order they should be considered
NHS Continuing Healthcare first, because it is the most complete and removes any charge. Funded Nursing Care next, where the person is in a nursing home and is not eligible for full funding. Local authority support last. Where there is any history of detention under the Mental Health Act, section 117 aftercare should also be considered early, since it cannot be charged for.
Joint packages
Where someone is not eligible for full NHS Continuing Healthcare but has health needs the local authority cannot properly meet, a joint package can be arranged. The NHS funds the health element and the local authority the social care element, with means testing applied only to the latter. This is a genuine middle ground rather than a consolation, though it should follow a proper eligibility decision rather than replace one.
The financial difference
For a self funding family the gap between NHS Continuing Healthcare and local authority support is typically the entire cost of care. Funded Nursing Care sits between them but covers only the nursing element, so the difference between it and full funding remains substantial. That gap is the reason the eligibility question repays proper attention.
Common confusions
Funded Nursing Care is regularly described as a form of continuing healthcare, which it is not. Being in a nursing home is regularly assumed to mean the NHS is responsible, which it does not. And a Funded Nursing Care award is sometimes treated as settling the question, when in fact anyone receiving it should have been considered for full NHS Continuing Healthcare first.
Key takeaway
NHS Continuing Healthcare is full NHS funding based on a primary health need and is not means tested. Funded Nursing Care is a flat contribution towards nursing input only. Local authority support is means tested. Consider them in that order, and consider section 117 early where it may apply.
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Frequently asked questions
Is Funded Nursing Care the same as CHC?
No. Funded Nursing Care is a flat NHS contribution towards registered nursing input in a nursing home and covers only that element. NHS Continuing Healthcare covers the full cost of the care package.
Should CHC be considered before FNC?
Yes. Anyone being considered for Funded Nursing Care should have been assessed for full NHS Continuing Healthcare first. An award of Funded Nursing Care does not settle the eligibility question.
Is Funded Nursing Care means tested?
No. It is paid at a flat rate directly to the nursing home regardless of the person's means, but the remainder of the fee is still payable by the person or the local authority.
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.