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. NHS England (2016) National Framework for Children and Young People's Continuing Care.
3. Children and Families Act 2014, c. 6. Available at: https://www.legislation.gov.uk/ukpga/2014/6/contents
4. The Care and Support (Charging and Assessment of Resources) Regulations 2014, SI 2014/2672.
Copywright
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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 the transition from children's and young people's continuing care to adult NHS Continuing Healthcare. It covers the two separate frameworks, why eligibility does not transfer automatically, when transition planning should begin, the adult assessment process, the interaction with education, health and care plans, and what to do where a young person is found not eligible as an adult.
Children's continuing care and the move to adult CHC
Children's continuing care and adult NHS Continuing Healthcare are separate systems with different criteria. A young person receiving one does not automatically receive the other, and families are frequently unprepared for that.
Two separate frameworks
Children's and young people's continuing care operates under its own national framework, distinct from the adult National Framework for NHS Continuing Healthcare. The criteria differ, the assessment tools differ, and the outcomes can differ for the same young person. The transition is therefore a fresh decision rather than an administrative renewal.
Eligibility does not transfer
This is the point families most need to know early. A young person receiving children's continuing care must be assessed against the adult test as they approach 18, and some are found not eligible. That is not necessarily an error. The adult test asks whether the person has a primary health need, which is a different question from the children's criteria.
When planning should start
Transition planning should begin well before the eighteenth birthday, and good practice starts it in the mid teens. The adult assessment should be arranged in time for a decision before the young person turns 18, so that any gap in funding is avoided and any challenge can be brought while support is still in place.
The adult assessment
It follows the standard adult process: a Checklist, then a full assessment using the Decision Support Tool by a multidisciplinary team, then a decision by the Integrated Care Board. Prepare for it as you would for any adult assessment, with care records, a domain-structured summary and needs described as they would be without the current package.
Interaction with education, health and care plans
Many young people in this position have an education, health and care plan. The health section of that plan is useful evidence for the adult assessment, since it records assessed health needs and provision. The two processes are separate, but the documentation from one supports the other and should be put before the multidisciplinary team.
If not eligible as an adult
The usual routes apply: local resolution, then the NHS England Independent Review Panel. Adult social care should also carry out a Care Act assessment, and a joint package may be appropriate. Do not let the young person fall between the two systems while the position is resolved, and ask both bodies to confirm interim arrangements in writing.
Key takeaway
The two systems are separate and eligibility does not transfer. Start planning in the mid teens, prepare for the adult assessment properly, use the education, health and care plan as supporting evidence, and secure written interim arrangements if the outcome is disputed.
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Frequently asked questions
Does children's continuing care continue after 18?
No. It is a separate framework with different criteria, and a fresh assessment against the adult test is required. Some young people found eligible as children are not eligible as adults.
When should transition planning start?
Well before the eighteenth birthday, and good practice begins in the mid teens. The aim is a decision before 18 so that any gap in funding is avoided.
Is the adult assessment the same process?
Yes, the standard adult route: Checklist, full assessment using the Decision Support Tool by a multidisciplinary team, then a decision by the Integrated Care Board.
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.