Continuing healthcare funding (often called NHS Continuing Healthcare or NHS CHC) is a package of care fully funded by the NHS for adults in England who have ongoing, complex health needs. It is one of the most misunderstood areas of the UK care system, yet it can make a significant difference to individuals and families by removing care costs that would otherwise be means-tested.
This detailed guide explains continuing healthcare funding clearly and accurately: what it is, who qualifies, how assessments work, what is covered, common challenges, and how to appeal decisions.
What Is Continuing Healthcare Funding?
Continuing healthcare funding is NHS-funded care provided to adults aged 18 and over whose primary need is a health need, rather than a social care need.
Key features:
Fully funded by the NHS
Not means-tested
Can be provided in any setting
Based on need, not diagnosis or income
In England, this funding is overseen by NHS England and delivered locally through Integrated Care Boards (ICBs).
What Does Continuing Healthcare Funding Cover?
When someone is eligible, the NHS covers all reasonable and necessary care costs, which may include:
Care home fees (with or without nursing)
Care provided in the person’s own home
Nursing care
Personal care
Equipment related to health needs
If a person receives NHS Continuing Healthcare, they should not be charged for their care, regardless of savings, property, or income.
Who Is Eligible for Continuing Healthcare Funding?
Eligibility is based on whether the person has a primary health need.
This means their needs are:
Complex
Intense
Unpredictable
Primarily related to health, not social care
It is not based on:
Age
Diagnosis alone
Where the person lives
Financial situation
The Concept of a Primary Health Need
A primary health need exists when care is required mainly to:
Manage, treat, or prevent health conditions
Address complex medical needs
Prevent serious deterioration
This is assessed by looking at:
Nature of needs
Intensity of needs
Complexity of needs
Unpredictability of needs
All four factors are considered together.
The Assessment Process for Continuing Healthcare Funding
Step 1: The Checklist Assessment
The process usually begins with a Checklist, which is a screening tool used to decide whether a full assessment is needed.
It can be completed by health or social care professionals
If the Checklist is positive, the process moves forward
A negative Checklist does not necessarily end eligibility forever
Step 2: Full Assessment (Decision Support Tool)
If the Checklist is positive, a full multidisciplinary assessment is carried out using the Decision Support Tool (DST).
This assessment looks at 12 care domains, including:
Behaviour
Cognition
Psychological and emotional needs
Communication
Mobility
Nutrition
Continence
Skin integrity
Breathing
Drug therapies and medication
Altered states of consciousness
Other significant care needs
Each domain is scored based on severity.
Step 3: Multidisciplinary Team Recommendation
A multidisciplinary team (MDT) reviews the evidence and makes a recommendation to the ICB.
The final decision must:
Follow national guidance
Be based on evidence
Consider all assessed needs
Where Continuing Healthcare Can Be Provided
Continuing healthcare funding can be used in:
Care homes
Nursing homes
The person’s own home
Supported living settings
There is no requirement for someone to live in a nursing home to qualify.
Continuing Healthcare vs Social Care Funding
This distinction causes much confusion.
Continuing Healthcare
Funded by the NHS
Not means-tested
Based on health needs
Local Authority Social Care
Means-tested
Based on support with daily living
Often requires financial contributions
If a person does not qualify for CHC, they may still receive NHS-funded nursing care or local authority support.
Common Conditions Associated with Continuing Healthcare
Certain conditions are commonly seen in CHC cases, but no condition automatically qualifies.
Examples include:
Advanced dementia
Parkinson’s disease
Multiple sclerosis
Severe brain injury
Complex mental health conditions
End-of-life care
Eligibility depends on needs, not diagnosis.
Continuing Healthcare Funding for Dementia
Many people with advanced dementia may qualify because:
Needs are complex and unpredictable
Care involves ongoing health management
Risks require skilled intervention
However, dementia alone does not guarantee eligibility. The focus remains on how needs present and are managed.
Reviews and Reassessments
Continuing healthcare funding is:
Reviewed regularly
Reassessed if needs change
Reviews must be:
Person-centred
Evidence-based
Fair and consistent
Funding should not be removed unless needs have genuinely changed.
Common Problems and Challenges
Families often experience:
Delays in assessment
Poor communication
Decisions based on diagnosis rather than needs
Inadequate evidence gathering
Understanding the process helps families challenge incorrect decisions.
Appealing a Continuing Healthcare Decision
If funding is refused or withdrawn, there is a right to appeal.
Appeals can include:
Local resolution
Independent review
Parliamentary and Health Service Ombudsman (in rare cases)
Appeals must focus on:
Evidence of health needs
Errors in applying criteria
Incomplete or inaccurate assessments
Many successful appeals are based on process failures, not changes in need.
Continuing Healthcare at End of Life
People with rapidly deteriorating conditions may receive fast-track continuing healthcare funding.
This:
Bypasses the full assessment process
Ensures care is provided quickly
Focuses on comfort and dignity
Fast-track funding should be implemented without delay.
Common Myths About Continuing Healthcare Funding
It is not only for people in nursing homes
It is not based on wealth or property
It is not limited to certain diagnoses
It is not automatically permanent or temporary
Eligibility depends solely on assessed health needs.
Practical Tips for Families
Ask for an assessment early
Keep detailed records
Attend assessment meetings
Request written reasons for decisions
Challenge incorrect assumptions
Being informed significantly improves outcomes.
Final Summary
Continuing healthcare funding is a vital NHS provision for adults with complex, ongoing health needs. It offers fully funded care, free from means-testing, and can be provided in various settings. Eligibility is determined by whether a person has a primary health need, assessed through a structured national process.
Although the system can be complex and challenging, understanding how continuing healthcare funding works empowers individuals and families to access the support they are entitled to and to challenge decisions when necessary.
