NHS Continuing Healthcare
NHS Continuing Healthcare Support
Social work led support from first assessment to appeal, Fast Track and retrospective claims, across England.
NHS Continuing Healthcare pays for a person's full care package where their needs amount to a primary health need. The process is demanding and the stakes are high. Nellie Supports provides social work led, fixed fee support at every stage. Every new case starts with an Independent Social Care Needs Assessment and Care Plan, charged once and never re-charged, which becomes the evidence base for everything that follows: Checklist screening, the Decision Support Tool, appeals through local resolution and the Independent Review Panel, mediation, Ombudsman referrals, urgent Fast Track advocacy and retrospective claims. We are not a law firm and not a claims company, and we never take a percentage of anything recovered.
From £1,100
Fixed fees, plus VAT
One working day
Enquiry triage response
England
Wales runs a separate framework
Peer reviewed
Every submission
What NHS Continuing Healthcare is
NHS Continuing Healthcare, usually shortened to CHC, is a package of care arranged and funded entirely by the NHS for a person whose overall needs are primarily health needs rather than social care needs. It can be provided in a care home, a nursing home or the person's own home.
It is not means-tested. Savings, income and property play no part in the decision, which is where CHC differs fundamentally from local authority social care. A person who has been paying for their own care for years may never have been assessed for the funding stream that would not have looked at their money at all.
The test that decides eligibility
Eligibility turns on whether the person has a primary health need, judged through four characteristics of their needs taken as a whole. Not a diagnosis, not a care setting, and never the person's money.
1.
Nature
The kind of needs the person has, and the kind of interventions they require.
1.
Intensity
How severe the needs are, how much support they demand and how continuously.
1.
Complexity
How the needs interact, and the skill required to manage the whole picture.
1.
Unpredictability
How far needs fluctuate, and the risk when changes are not anticipated.
How the process runs
From the first screening to the review a year later. Most families meet the process at speed, at a hospital discharge or a care review, with little warning.
1.
Checklist
A screening tool. A positive result does not award funding, it triggers the full assessment.
1.
Decision Support Tool
A multidisciplinary team scores needs across the twelve care domains.
1.
ICB decision
The Integrated Care Board makes the eligibility decision and confirms it in writing.
1.
Challenge
Six months to challenge, starting with local resolution, then the Independent Review Panel.
1.
Review
Eligibility is reviewed at three months, then annually. Funding can be withdrawn.
NHS Continuing Healthcare
Assessment, appeal, urgent Fast Track and retrospective support across the full CHC pathway in England.
Independent Social Care Needs Assessment & Care Plan
The mandatory first step for every new CHC case. Independent needs assessment and written care plan, charged once per client.
Case Review & Merits Assessment
Case review and merits opinion, the appeal gateway for new clients with no prior Nellie Supports involvement.
Checklist Screening Support
Preparation and challenge support for the CHC Checklist screening stage.
CHC Assessment Support
Preparation and representation for the Checklist and the Decision Support Tool.
CHC Appeal Application
We draft and submit your CHC appeal application.
CHC Mediation
Representation at ICB mediation, where the ICB offers it.
CHC Appeal Support
Challenge a refusal through local resolution and the Independent Review Panel.
NHS Independent Review Panel
Application and representation at the Independent Review Panel, handled as one merged stage.
Ombudsman (PHSO) Referral
Support with a non-funding referral to the Parliamentary and Health Service Ombudsman.
Fast Track Review Advocacy
Advocacy and attendance at Fast Track reviews for people with rapidly deteriorating conditions.
Retrospective CHC Claims
Fixed fee claims for periods of care that were never assessed, starting with a £495 qualification review credited if you proceed.
Frequently asked questions
Is CHC means-tested?
No. Eligibility is decided on the person's needs through the primary health need test. Savings, income and property play no part in it. The means test belongs to local authority social care, which is a separate system.
Does a positive Checklist mean funding is awarded?
No. The Checklist is a screening tool. A positive result triggers the full assessment, where a multidisciplinary team scores needs across the twelve care domains before the Integrated Care Board makes the eligibility decision.
How long do we have to challenge a decision?
There is a six month window to challenge an eligibility decision. If you are close to the edge of it, act promptly and say so when you seek help.
Can you guarantee the person will be found eligible?
No, and no honest provider can. Eligibility is the Integrated Care Board's decision. Our job is to make sure it is made on complete, accurate evidence.
Do you charge a percentage of what is recovered?
Never. Fixed fees only, published and confirmed in writing before instruction. We take no share of any funding or repayment.
Guides to the CHC process
NHS Continuing Healthcare explained
What CHC is, who funds it, and why the decision never looks at the person's money.
CHC eligibility and primary health need
The test that decides eligibility, and the four characteristics it turns on.
The CHC assessment process
From the Checklist through the Decision Support Tool to the ICB decision.
Challenging a CHC decision
What a not eligible letter means, and the routes open to you afterwards.
Who pays for care fees
Where NHS funding ends and local authority or self funding begins.
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. This page describes NHS Continuing Healthcare in England. Wales operates its own Continuing NHS Healthcare framework through health boards.