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. Mental Capacity Act 2005, c. 9. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents
4. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/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 addresses NHS Continuing Healthcare from the position of a Court of Protection deputy. It covers the scope of property and affairs authority, the duty to manage the protected party's assets, best interests considerations, funding the work from the protected party's funds, record keeping and reporting to the Office of the Public Guardian, the position of health and welfare deputies, and when to seek directions.
Deputy authority and CHC appeals
For a property and affairs deputy paying care fees, NHS Continuing Healthcare is a question about whether the protected party should be paying at all. That places it squarely within the territory a deputy is appointed to manage.
Why it falls within the role
A property and affairs deputy is appointed to manage the protected party's assets in their best interests. Where care fees are being paid that may be the responsibility of the NHS, establishing the position is ordinarily consistent with that duty. The financial consequence is frequently the single largest outgoing from the estate.
Check the order
The scope of authority derives from the order itself, and orders vary. Most standard property and affairs orders are wide enough to cover pursuing a funding question and instructing professionals to assist. Where the order is restricted, or the position is unclear, the sensible course is to take advice or seek directions rather than proceed on assumption.
Best interests
The decision to pursue a claim is one taken in the protected party's best interests, taking account of their past and present wishes, beliefs and values, and the views of those close to them. In most cases recovering or avoiding substantial care costs is clearly in their interests, but the reasoning should be recorded rather than assumed.
Funding the work
Where a deputy instructs professional assistance, the cost is ordinarily met from the protected party's funds as an expense of the deputyship, subject to the terms of the order and to it being a reasonable expense. Proportionality matters: the cost should be sensible relative to the sums at stake, and that assessment should be documented.
Records and reporting
Deputies report annually to the Office of the Public Guardian. Decisions to pursue a claim, to instruct professionals and to incur costs should be recorded contemporaneously with the reasoning. A clear file showing why the deputy considered the step to be in the protected party's interests is straightforward to produce at the time and awkward to reconstruct later.
Health and welfare deputies
Health and welfare deputyships are comparatively rare. Where one exists, the deputy may be involved in decisions about the assessment process and about care arrangements, but the financial claim itself sits with whoever holds property and affairs authority. Where the two are held by different people, coordinate early.
When to seek directions
Where the order is ambiguous as to scope, where a substantial cost is contemplated and its recoverability is uncertain, or where family members disagree materially about whether a claim should be pursued. Directions are slower but they resolve the question, and the position on costs is then clear.
Key takeaway
Pursuing CHC is ordinarily within property and affairs authority given the financial consequence. Check the order, record the best interests reasoning, keep costs proportionate and documented, and seek directions where scope or family agreement is genuinely unclear.
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Frequently asked questions
Can a deputy pursue a CHC claim?
Ordinarily yes under a property and affairs order, since establishing whether the protected party should be paying care fees falls within managing their assets. The scope of the particular order should be checked.
Can professional costs be paid from the funds?
Ordinarily as an expense of the deputyship, subject to the order and to the cost being reasonable. Proportionality relative to the sums at stake matters and should be documented.
Does this need a best interests decision?
The decision to pursue should be taken and recorded on best interests principles, taking account of the person's wishes, beliefs and values and the views of those close to them.
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.