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NHS Continuing Healthcare
CHC Versus Funded Nursing Care
Two NHS funding streams, and how they fit together
What is the difference?
NHS Continuing Healthcare is a full package of care arranged and funded by the NHS for a person whose overall needs amount to a primary health need. NHS-funded Nursing Care is narrower: a contribution by the NHS towards the nursing care costs of a person in a nursing home who is not eligible for CHC. CHC is considered first; FNC is the fallback for nursing home residents.
Plain English
For families and professionals
England and Wales
National coverage
Registered professionals
Written and reviewed
The two funding streams are regularly confused, and the confusion is expensive: a family told the person has NHS funding may not realise it is the nursing contribution rather than the full package. This guide describes the system in England. Wales operates its own Continuing NHS Healthcare framework through health boards.
Who each stream applies to
In broad terms:
- NHS Continuing Healthcare: any setting, where the person's overall needs amount to a primary health need
- NHS-funded Nursing Care: nursing home residents with nursing needs who are not eligible for CHC
- Neither is means-tested: both turn on needs, not on savings or property
How to prepare
Questions worth asking:
- Has CHC been properly considered before FNC was applied?
- Which funding stream does the current paperwork actually refer to?
- If FNC is in place, when was CHC last looked at, and have needs increased since?
- Is the funding position reflected in the care home contract and the fee statements?
Where people often go wrong
- Treating FNC as if it were the full CHC package
- Accepting FNC without CHC having been considered first
- Assuming FNC is the end of the road when needs later increase: a new Checklist can be sought
- Letting the funding label in the paperwork go unchecked against what is actually being paid
- Treating FNC as if it were the full CHC package
- Accepting FNC without CHC having been considered first
- Assuming FNC is the end of the road when needs later increase: a new Checklist can be sought
- Letting the funding label in the paperwork go unchecked against what is actually being paid
How the two decisions relate
CHC comes first in the order of consideration. A person is assessed for NHS Continuing Healthcare, and only where they are found not eligible does NHS-funded Nursing Care arise, and then only for nursing home residents with nursing needs. FNC contributes towards the nursing element of the home's fees; it does not fund the whole placement.
Because the streams are decided in sequence, a weak CHC assessment can quietly become an FNC outcome. That is why the assessment stage, and the accuracy of the evidence at it, matters even for families who expect the answer to be FNC.
A social work led multidisciplinary practice
Nellie Supports is a social work led multidisciplinary specialist practice working across England and Wales, operating through a permanent, full-time employed team that has completed more than 11,000 assessments. Our NHS Continuing Healthcare work prepares and presents the evidence of need at every stage of the process.
Related pages
Frequently Asked Questions
Does FNC cover the whole care home fee?
No. It is a contribution towards the nursing care element of a nursing home placement, not funding for the whole placement.
Can a person move from FNC to CHC?
Yes, where their needs increase to the point that the overall picture amounts to a primary health need. A new Checklist starts that consideration.
Is FNC means-tested?
No. Like CHC, it turns on needs rather than on the person's money. The means test belongs to local authority social care, which is a separate system.
This guide is general information about NHS Continuing Healthcare in England, not legal advice, and does not create a professional relationship. Nellie Supports provides independent social work assessment, evidence and advocacy support. We do not provide regulated legal advice, and where a legal remedy is needed we will say so and support your solicitor's work.