NHS Continuing Healthcare
NHS Continuing Healthcare Support
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 support at every stage, with fees published and confirmed in writing before instruction. If we have not worked with you before, every service starts with an independent needs assessment and care plan, included in the new client price and charged once. We are not a law firm and not a claims company, and we never take a percentage of anything recovered.
Social work led support from first assessment through reviews and appeals to retrospective claims, across England.
At a glance
Stages covered
• Checklist
• Decision Support Tool
• Reviews
• Appeals
• Independent Review Panel
• Ombudsman
• Retrospective claims
Framework
National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, 2022 revision
Means tested
No. Savings, income and property play no part in the decision
Fees
From £1,100 plus VAT, never a percentage of anything recovered
Coverage
England. Wales runs its own Continuing NHS Healthcare framework
From £1,100
Published fees, plus VAT
One working day
Enquiry triage response
England
Wales runs a separate framework
Peer reviewed
Every submission
Plain-English explanation
What is NHS Continuing Healthcare?
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. Eligibility turns on whether the person has a primary health need, judged through the nature, intensity, complexity and unpredictability of their needs taken as a whole. It is not a diagnosis test, it does not depend on the care setting, and it never looks at the person’s money.
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.
A refusal is not the end of the process
Most CHC decisions that change, change on appeal. A not eligible letter records the Integrated Care Board’s view on the evidence in front of it, and the evidence in front of it is usually incomplete. The question is whether the person’s needs were described properly, not whether the decision has already been made.
NHS Continuing Healthcare
11 assessments
Assessment, review, appeal and retrospective support across the CHC pathway in England.
CHC Consultation and Action Plan
A consultation with a registered social worker about where you are in the CHC process, followed by a written action plan. The place to start if you are unsure which service you need.
£280 plus VAT
Independent Social Care Needs Assessment & Care Plan
Included in the new client price of every CHC service and charged once. Independent needs assessment and written care plan, also available on its own.
£1,100 plus VAT
Case Review & Merits Assessment
Case review and written merits opinion, the first step for new clients before any appeal is instructed.
From £1,950 plus VAT
Checklist Advocacy and Attendance
Standard: a prospective Checklist, advocacy for the formal screening and attendance at the meeting. Enhanced adds the needs assessment and care plan.
From £1,250 plus VAT
CHC Assessment Support: DST and MDT Meeting
Evidence prepared across the twelve care domains of the Decision Support Tool (DST) and representation at the multi-disciplinary team (MDT) meeting.
From £3,750 plus VAT
CHC Review Support
Independent evidence for the 3 month and annual reviews of a care package, where a reassessment can reduce or withdraw funding.
From £900 plus VAT
CHC Mediation
Representation at ICB mediation, where the ICB offers it.
From £1,750 plus VAT
CHC Appeal Support: Local Resolution
Written submission and representation at local resolution with the Integrated Care Board, the first stage of a CHC appeal. The Independent Review Panel is a separate service.
From £3,950 plus VAT
NHS Independent Review Panel
Application and representation at the Independent Review Panel, handled as one merged stage.
From £6,250 plus VAT
Ombudsman (PHSO) Referral
Support with a referral to the Parliamentary and Health Service Ombudsman about how the process was handled.
From £2,500 plus VAT
Retrospective CHC Claims
Claims for periods of care that were never assessed, starting with a £495 records review credited if you proceed. Never a percentage.
From £6,950 plus VAT
Where you are in the process
Where are you in the process?
The right support depends on the stage you are at, not on the diagnosis. These are the four points at which families and professionals usually reach us. Every new case also includes the Independent Social Care Needs Assessment and Care Plan, charged once and never re-charged.
Assessment option | Suitable for | What is included |
|---|---|---|
Before a decision | A Checklist or Decision Support Tool is coming, or nobody has ever considered CHC | Independent social care needs assessment and care plan; Checklist screening preparation and challenge; Decision Support Tool preparation; attendance and representation at the MDT |
After a refusal | A not eligible decision has been made and you want it reconsidered | Case review and merits opinion; appeal application drafted and submitted; local resolution submission and attendance; mediation where the ICB offers it; Independent Review Panel application and representation; Ombudsman referral |
Funding already in place | A three month or annual review is coming, and the package could be reduced or withdrawn | Current independent care assessment; needs mapped to the twelve care domains; Checklist evidence included; written care plan where the review is contested |
For care already paid for | Care was funded privately during a period that was never properly assessed | Records review before any full claim; full retrospective claim prepared and submitted; published fees, never a percentage of any repayment |
Checklist
A screening tool. A positive result does not award funding, it triggers the full assessment.
Decision Support Tool
A multidisciplinary team scores needs across the twelve care domains and makes a recommendation.
ICB decision
The Integrated Care Board makes the eligibility decision and confirms it in writing.
Challenge
Deadlines are set in your decision letter, commonly six months. Local resolution comes first, then the Independent Review Panel.
Review
Eligibility is normally reviewed at three months, then at least annually. Funding can be withdrawn.
How the NHS process runs
How the NHS process runs
Deliverable
Inside a Nellie Supports CHC submission
Whatever stage we are instructed at, the work follows the same structure: evidence, analysis and conclusion in a clear line that an Integrated Care Board, a panel or the Ombudsman can scrutinise.
The instruction and the stage being addressed
Records, care notes and correspondence reviewed
An independent account of day-to-day needs
Evidence mapped to the twelve care domains
Analysis against the four key characteristics
Where the process or the evidence fell short
Conclusion and professional opinion
Peer review by a second qualified professional
Independent Social Care Needs Assessment and Care Plan
£1,100 + VAT
£1,100 plus VAT. Included in the new client price of every CHC service and charged once per client. Also available on its own, and anyone who has it becomes a returning client for every other CHC service.
Case Review and Merits Assessment
£1,950 + VAT
£1,950 plus VAT. For new clients, the first step before any appeal is instructed, so we only take forward appeals with real merit. Existing clients skip this step.
Transparent pricing
How CHC fees work
Fees are published and confirmed in writing before instruction, plus VAT and travel where applicable. We never take a percentage of any funding or repayment. If we have not worked with you before, every service starts with an independent needs assessment and care plan. It is included in the new client price, charged once and carried through every later stage.
Who we work with
For solicitors, deputies, care providers and advisers
Instruction is straightforward and the evidential standard is consistent whichever stage we are brought in at:
Scope confirmed in writing
The stage, the fee and the timescale are confirmed in writing before instruction.
Evidence in the language of the framework
Needs are described against the twelve care domains and the four key characteristics, not in general terms.
Peer review as standard
A second qualified professional reviews the work before it is submitted.
Honest merits advice
Where a case has no realistic prospect, we say so before you spend anything further on it.
For families
A clear fee, stated before instruction and confirmed in writing, with no percentage of anything recovered. We explain what stage you are at in plain English, tell you honestly whether it is worth pursuing, and make sure the person’s needs are described properly to the people making the decision.
For professionals
A permanent, employed multidisciplinary team of Social Work England and Social Care Wales registered professionals. Evidence is prepared against the twelve care domains and the four key characteristics, peer reviewed by a second qualified professional, and structured for scrutiny at local resolution, Independent Review Panel or the Ombudsman.
Provider evidence
Why choose Nellie Supports for NHS Continuing Healthcare
Social work led support across the whole CHC pathway, delivered by a permanent full-time employed team that has completed more than 11,000 formal assessments and reports.
Why instruct Nellie Supports
Social work led, not a claims company
Registered professionals prepare and present the evidence of need. We are not a law firm and not a claims company.
Published fees, never a percentage
Every fee is published and confirmed in writing before instruction. We take no share of any funding or repayment recovered.
One assessment, carried through
The needs assessment is charged once and carried through every later stage of your case, never re-charged.
Employed, not outsourced
A permanent full-time multidisciplinary team, not an ad hoc associate, contractor or referral-panel model.
Peer review as standard
Everything we prepare is reviewed by a second qualified professional before it is used.
Honest about outcomes
Eligibility is the Integrated Care Board’s decision. We never promise a result, and we say so plainly when a case is weak.
The situation
A daughter contacted us after her father, who had advanced Parkinson’s disease and a history of aspiration, was found not eligible following a Decision Support Tool meeting she had attended alone. The letter recorded most domains a level lower than the care home’s own notes supported.
The barrier
The family had no independent record of his needs. The multidisciplinary team had worked from a care plan written for a different purpose, and the night-time interventions, the choking risk and the unpredictability of his swallowing had never been written down in the language the process scores.
How Nellie Supports helped
A registered professional completed an independent needs assessment and care plan, then a case review and merits assessment. Both concluded the appeal had real merit. We drafted the appeal, mapped the evidence to the twelve care domains and the four key characteristics, and represented the family at local resolution.
Why it mattered
The family did not have to argue their own case, and the decision was reconsidered on the complete picture of his needs rather than on a care plan written for another purpose. Eligibility is always the Integrated Care Board’s decision; our part is making sure it is made on the right evidence.
An illustrative example drawn from the pattern of instructions we receive. It does not describe an identifiable person.
In practice
How CHC support works in practice
Common questions
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?
Your decision letter should state the deadline for requesting a review. Many ICBs allow six months, so act promptly. Late requests may still be considered depending on the circumstances, and if you are close to a stated deadline, 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. Published fees only, confirmed in writing before instruction. We take no share of any funding or repayment.
Can we claim back care fees already paid?
Sometimes. A retrospective claim, often called a previously unassessed period of care, looks at a period when the person was paying for care and was never properly assessed for CHC. It depends on the records that still exist, which is why we begin with a records review before any full claim is prepared.
Do you cover Wales?
This service covers England. Wales operates its own Continuing NHS Healthcare framework through health boards, and the process and terminology differ. Tell us where the person lives and we will confirm what we can do.
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.
Supporting guidance
Guides to the CHC process
Mental capacity assessments
Decision-specific capacity assessments for finances, property, care, residence and litigation.
Expert capacity reports and reviews
Independent expert reports and critical review of existing capacity evidence.
Lasting Power of Attorney services
Certificate provider services and capacity evidence for LPA decisions.
Other support from our practitioners
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