NHS Continuing Healthcare
NHS Continuing Healthcare Explained
What CHC is, who pays for it, and why eligibility turns on health need rather than diagnosis, setting or savings.
What is NHS Continuing Healthcare?
NHS Continuing Healthcare is a package of care funded entirely by the NHS for adults whose main need for care is a health need. It is arranged and paid for by an Integrated Care Board and covers the full cost of care, including care home accommodation. Eligibility depends on having a primary health need, not on a diagnosis or on savings.
Plain English
For families and professionals
England and Wales
National coverage
Registered professionals
Written and reviewed
For most families, CHC is the difference between paying for care and having it funded in full. It is not means tested, it is not tied to any particular condition, and it is not something a local authority can award. It is decided by the NHS, against a national framework, on the basis of the care a person actually needs.
Who CHC is for
CHC is assessed on need rather than on setting or label. It can apply to someone living in their own home, in a care home, or in supported living.
- Adults aged 18 or over with significant ongoing health needs
- People whose needs are managed through a nursing or clinical care plan
- People with a rapidly deteriorating condition who may qualify through Fast Track
- People already funding care privately who have never been assessed
- People whose local authority has raised an eligibility concern
How to prepare
Most families come to CHC late, after care is already being paid for. A small amount of preparation changes what the assessment sees.
- Ask for a Checklist in writing and keep a copy of the request
- Gather GP records, hospital discharge summaries and specialist letters
- Keep a daily record of what care is actually delivered, and by whom
- Note anything unpredictable: falls, infections, admissions, behaviour that varies
- Ask who will attend the assessment and request enough notice to arrange support
Where people often go wrong
- Accepting that a diagnosis such as dementia automatically rules CHC in or out
- Assuming savings or property make someone ineligible
- Allowing a Checklist to be completed without the family present
- Describing a good day rather than a typical week
- Treating the decision as being about the care setting rather than the level of need
- Accepting that a diagnosis such as dementia automatically rules CHC in or out
- Assuming savings or property make someone ineligible
- Allowing a Checklist to be completed without the family present
- Describing a good day rather than a typical week
- Treating the decision as being about the care setting rather than the level of need
What CHC pays for
Where a person is found eligible, the NHS meets the full cost of their assessed care needs. In a care home that includes the accommodation as well as the care. At home it covers the assessed package of care and support. There is no personal contribution and no means test. Eligibility is reviewed periodically, usually within three months of the first decision and annually after that.
A social work led multidisciplinary practice
Nellie Supports is an independent social work practice. We prepare families for CHC assessments, attend the Decision Support Tool meeting, and evidence need against the national framework in the language the Integrated Care Board is required to apply. We are independent of both the NHS and the local authority.
Frequently Asked Questions
Is NHS Continuing Healthcare means tested?
No. CHC is not means tested. Savings, income, property and pensions are not considered at any stage. Eligibility is decided solely on whether a person has a primary health need. Where a person is found eligible, the NHS meets the full cost of their assessed care, including care home accommodation.
Does a dementia diagnosis mean someone qualifies for CHC?
No. No diagnosis qualifies or disqualifies a person automatically. The assessment looks at the nature, intensity, complexity and unpredictability of a person's needs, and at how much skilled intervention those needs require. Two people with the same diagnosis can reach different outcomes because their day to day needs differ.
Who decides whether someone gets CHC?
The Integrated Care Board makes the decision. A multidisciplinary team completes the Decision Support Tool and makes a recommendation, and the ICB is expected to accept it other than in exceptional circumstances. The local authority does not decide CHC eligibility, although its staff often sit on the assessing team.
How long does the CHC process take?
The national framework expects a decision within 28 days of a positive Checklist, although in practice timescales vary considerably between Integrated Care Boards. Fast Track referrals, for people with a rapidly deteriorating condition that may be entering a terminal phase, are intended to be decided far more quickly than the standard route.
This page explains the NHS Continuing Healthcare framework in England. It is general information rather than legal advice, and it does not replace an assessment of an individual's needs. Nellie Supports is an independent social work practice and is not part of the NHS.