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. R v North and East Devon Health Authority, ex parte Coughlan [2000] 2 WLR 622.
3. R (Grogan) v Bexley NHS Care Trust and others [2006] EWHC 44 (Admin).
4. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
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 applies to adults under 65. It covers the absence of any age criterion, the conditions most commonly involved, the transition from children's continuing care at 18, the particular difficulties younger adults face in assessment and placement, the relevance of independence and social participation, and how to approach an assessment.
NHS Continuing Healthcare eligibility for adults under 65
Adult NHS Continuing Healthcare is for people aged 18 and over who have a primary health need. There is no upper age limit. Under-18s use the children and young people’s continuing care framework, with transition planning before adulthood.
There is no age criterion
The minimum age for adult CHC is 18. Eligibility is not limited by an upper age, diagnosis, setting or wealth. For a young person approaching 18, children’s continuing care and adult CHC have different frameworks and should be coordinated through transition planning.
The conditions most often involved
Acquired brain injury, spinal cord injury, advanced multiple sclerosis, motor neurone disease, Huntington's disease, severe learning disability with complex health needs, and the consequences of severe mental illness. Younger onset dementias also fall into this group and bring particular difficulties around services configured for older people.
Transition from children's continuing care
Young people receiving children's continuing care do not transfer automatically to adult NHS Continuing Healthcare at 18. A fresh assessment against the adult test is required, and the criteria are not identical, so some young people who received children's continuing care are not found eligible as adults. Planning should begin well before the eighteenth birthday.
Where assessments go wrong for younger adults
Two patterns recur. The first is assessment tools and assessors more accustomed to older people, which can lead to needs being framed in terms that do not fit. The second is physical strength and mobility combined with severe cognitive or behavioural impairment, which is a demanding combination frequently under-recorded because the person appears physically capable.
Independence and participation
For younger adults, needs relating to education, employment, social participation and family life are often central to wellbeing but sit awkwardly in a tool designed around clinical domains. They are not irrelevant, since they inform how needs are met and the risks arising, but the eligibility decision itself turns on the assessed health needs.
Placement difficulty
Services for adults with complex needs under 65 are limited in many areas, and placement breakdown is common. Where it has occurred, document it. Repeated breakdown is meaningful evidence of complexity and unpredictability, and it frequently demonstrates the level of skill required more clearly than any clinical letter.
Key takeaway
There is no age criterion and the test is identical. Watch for needs being under-recorded where the person is physically strong but severely impaired, plan the transition from children's continuing care well before 18, and document any placement breakdown as evidence.
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Adult CHC begins at 18 and has no upper age limit. Start transition planning early where a young person may need adult CHC; do not assume the child’s package automatically continues or that a new diagnosis is required.
Frequently asked questions
Is there a minimum age for CHC?
No. NHS Continuing Healthcare applies to adults of any age on exactly the same test. Age is not a factor at any stage of the assessment or decision.
Does children's continuing care transfer automatically at 18?
No. A fresh assessment against the adult test is required and the criteria are not identical, so some young people found eligible as children are not eligible as adults. Plan well before the eighteenth birthday.
Which conditions are most common in this group?
Acquired brain injury, spinal cord injury, advanced multiple sclerosis, motor neurone disease, Huntington's disease, severe learning disability with complex health needs, and younger onset dementias.
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.