NHS Continuing Healthcare (CHC)
Fully funded NHS care for people with a 'primary health need' — covering all care costs whether at home or in a care home, with no means test.
Key Facts
- Fully funded by the NHS — no means test, no contribution from savings
- Covers both home care and residential care home fees
- Eligibility is based on health needs, not financial situation
- The 'primary health need' test looks at nature, complexity, intensity and unpredictability
- A fast-track pathway exists for people who are rapidly deteriorating
- If you have paid for care that should have been CHC-funded, you may be able to reclaim costs
What Is NHS Continuing Healthcare?
NHS Continuing Healthcare is a package of ongoing care arranged and fully funded by the NHS for adults with significant, complex health needs. Unlike social care, which is means-tested, CHC is entirely free — the NHS pays for everything, whether you receive care at home or in a care home.
The crucial distinction is that CHC is for people whose primary need is a health need, rather than a social care need. Many people who need and qualify for it are never told it exists.
How Is Eligibility Assessed?
Eligibility is determined by a two-stage process. First, there is a checklist screening tool — completed by a nurse, social worker or other health professional. If the checklist suggests you may qualify, a full assessment is carried out using the Decision Support Tool (DST), which looks at 12 care domains including cognition, behaviour, communication, psychological needs, mobility, nutrition, continence, skin integrity, breathing, drug therapies, altered states of consciousness and other needs.
The key question is whether your primary need is a health need — not whether you have a high level of need overall.
Fast Track CHC
If you are rapidly deteriorating and your condition may be entering a terminal phase, you can access CHC funding via a fast-track pathway. A clinician (GP, specialist nurse or consultant) completes a fast-track tool and submits it to the Integrated Care Board (ICB). Funding should be in place within 48 hours.
If You Are Refused CHC
Many people who qualify are refused CHC. If you believe the assessment was wrong, you have the right to request a local review and then an independent review panel. You can also complain to the Parliamentary and Health Service Ombudsman. Get independent advice from a solicitor or advocacy organisation — this is a complex area and errors in assessments are common.