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. Department of Health and Social Care. Care and support statutory guidance. Available at: https://www.gov.uk/government/publications/care-act-statutory-guidance
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 joint packages of care, where NHS Continuing Healthcare does not apply in full but the NHS still funds part of a person's care. It covers when a joint package arises, how responsibility is divided, what is means tested, why a joint package should follow rather than replace an eligibility decision, and how to challenge a package that appears to understate NHS responsibility.
Joint packages of care: shared NHS and council funding
Not every case falls cleanly on one side of the NHS and council boundary. Where someone is not eligible for full NHS Continuing Healthcare but has health needs a council cannot properly meet, a joint package divides the responsibility.
What a joint package is
An arrangement where the NHS funds the health element of a person's care and the local authority funds the social care element. The person is means tested only on the local authority portion. It is a genuine middle position rather than a consolation prize, and for someone self funding it can still represent a substantial reduction in what they pay.
When it arises
Where a full assessment concludes the person does not have a primary health need, but they nonetheless have identified health needs that go beyond what social care can properly meet. The joint package addresses those specific needs while leaving the remainder with the local authority.
How responsibility is divided
The division should follow the assessed needs rather than a formula. Health needs identified in the assessment fall to the NHS, and the balance to the local authority. In practice the split is often expressed as a contribution towards a package rather than as separately delivered services, which can make it hard to see what is being funded.
What is means tested
Only the local authority element. The NHS contribution is not means tested and is not affected by income, capital or property. The person is financially assessed on the council portion in the usual way, so the effect of a joint package is to reduce rather than remove any charge.
It should follow an eligibility decision
This is the point that matters most. A joint package should be arranged after a proper NHS Continuing Healthcare eligibility decision, not instead of one. Where a joint package is offered as a way of resolving a dispute without ever deciding eligibility, ask for the eligibility decision in writing, since a joint package carries no appeal rights in the same way.
Challenging the split
Where you consider the NHS element understates health responsibility, that is worth raising, though it is a different argument from an eligibility challenge. Identify the specific health needs you say the NHS should be meeting, and the evidence for them. If the underlying eligibility decision is also disputed, run that separately through local resolution.
Key takeaway
A joint package splits responsibility, with means testing applied only to the council element. It should follow a proper eligibility decision rather than replace one, and if it is being offered instead of a decision, ask for the decision in writing.
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Frequently asked questions
Is a joint package means tested?
Only the local authority element. The NHS contribution is not means tested and is unaffected by income, capital or property, so a joint package reduces rather than removes any charge.
Is it the same as Funded Nursing Care?
No. Funded Nursing Care is a flat NHS contribution towards registered nursing input in a nursing home. A joint package divides responsibility according to the person's assessed health and social care needs.
Should we accept one instead of an assessment?
No. Ask for the eligibility decision in writing first. A joint package offered as a way of avoiding a decision leaves you without the appeal rights an eligibility decision carries.
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.