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
Copywright
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Abstract
This guide sets out what NHS Continuing Healthcare funding covers. It distinguishes the position in a care home from care at home, explains the treatment of accommodation, personal and nursing care, equipment, therapies and medication, identifies the costs that remain the person's own responsibility, and addresses top-up fees and preferred placements.
What NHS Continuing Healthcare covers and what it does not
Eligibility for NHS Continuing Healthcare means the NHS meets the cost of the assessed care package. What that includes depends heavily on setting, and the difference between a care home and someone's own home causes a lot of confusion.
The general principle
The Board meets the cost of meeting the person's assessed health and care needs. What falls inside that depends on the package the assessment identifies, which is why the care plan matters as much as the eligibility decision. Anything required to meet assessed needs should be funded, and anything that is an ordinary living cost should not.
In a care home
Where an eligible person lives in a care home, the full cost of the placement is met. That includes accommodation, food and living costs as well as the personal and nursing care. This is the clearest practical consequence of eligibility, and it is why nobody eligible should be paying care home fees or a top-up for the placement identified as meeting their needs.
In the person's own home
At home the position is narrower. The package covers the assessed care, which may include personal care visits, nursing input, waking or sleeping night support, equipment and specialist input. It does not cover rent, mortgage, council tax, utilities, food or general household costs. Those remain the person's own responsibility, since they would arise regardless of care needs.
Equipment and adaptations
Equipment required to meet assessed health needs, such as pressure relieving mattresses, hoists, specialist beds and continence products, should be provided as part of the package. Larger property adaptations are usually handled through other routes, including local authority disabled facilities arrangements, and can involve a separate assessment and different funding rules.
Therapies and clinical input
Input from physiotherapy, occupational therapy, speech and language therapy, dietetics and specialist nursing forms part of NHS provision where required to meet assessed needs. In practice these are often delivered through existing community services alongside the funded package rather than being separately purchased, which can make them less visible in the paperwork.
Medication and ordinary NHS services
Prescriptions, GP services and hospital treatment are provided through ordinary NHS routes as they would be for anyone else, and eligibility does not change that. Prescription charges apply in the same way and according to the same exemptions, which surprises some families who expect all health-related costs to disappear.
Top-up fees
A person eligible for NHS Continuing Healthcare should not be asked to pay a top-up for the placement that meets their assessed needs. Where a family chooses a more expensive home that is not required to meet those needs, the position is different and more complicated. If you are being asked for a top-up while eligible, ask the Board in writing to explain the basis for it.
What is not covered
Ordinary living costs at home, general household expenses, private services chosen in addition to the assessed package, and placements more expensive than needed to meet assessed needs. Social and leisure activities are sometimes funded where they form part of meeting an assessed need, but not simply as a preference.
Key takeaway
In a care home, eligibility covers the full placement cost including accommodation. At home, it covers the assessed care package but not ordinary living costs. Nobody eligible should be paying a top-up for the placement identified as meeting their needs.
Frequently asked questions
Does CHC pay care home fees in full?
Yes. Where an eligible person lives in a care home, the full cost of the placement is met, including accommodation and living costs as well as care. No fees or top-ups should be payable for that placement.
Does it cover rent or a mortgage at home?
No. At home the funding covers the assessed care package, not ordinary living costs. Rent, mortgage, council tax, utilities and food remain the person's own responsibility.
Are prescriptions free under CHC?
Not automatically. Prescriptions are provided through ordinary NHS routes and the usual charges and exemptions apply, so eligibility does not by itself remove prescription charges.
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.