What is Continuing Healthcare Funding and Could it Cover the Cost of Your Loved One's Care?

NHS Continuing Healthcare (usually abbreviated to CHC) is one of the most underused forms of care funding in England. It can cover the full cost of care at home for people with significant health needs. It is not means-tested, which means it is not based on savings or income. And yet many families who would qualify for it have never heard of it.

We talk to families about CHC regularly, and the most common thing we hear is some variation of: "I had no idea that was even an option."

This guide is for those families. We will explain what CHC is, who is eligible, how the process works, and what to do if you believe someone you care for might qualify.

What is NHS Continuing Healthcare?

NHS Continuing Healthcare is a package of care that is fully funded by the NHS, not by the local authority or the family, for people whose primary need is a health need rather than a social care need.

The distinction matters. If a person's main requirement is social care (help with daily tasks, companionship, personal care) that falls under local authority responsibility and is means-tested. But if their primary need is healthcare (managing a complex medical condition, specialist clinical support, ongoing nursing requirements) it falls under the NHS, and CHC may apply.

CHC can fund care at home, in a care home, or in a nursing home. When it funds home care, it typically covers all the costs of a full care package, including complex or live-in care.

"Some of our most intensive care packages are funded through Continuing Healthcare. The families we support through CHC often tell us they genuinely did not know the NHS could fund care at this level. It is worth every family checking, because if it applies it removes a very significant financial burden."
Blossom Healthcare Solutions

Who is eligible for CHC?

Eligibility is based on need, not diagnosis. There is no single condition that automatically qualifies someone, and no condition that automatically disqualifies them. What matters is the nature, complexity, intensity and unpredictability of the person's needs as a whole.

CHC tends to be relevant for people with:

• Acquired brain injury
• Motor neurone disease (MND)
• Advanced multiple sclerosis or Parkinson's disease
• Spinal cord injuries
• Complex dementia with significant behavioural or clinical needs
• Conditions requiring clinical interventions at home such as PEG feeding, ventilator support or tracheostomy care
• Progressive conditions in the later stages, including cancer
• Palliative and end-of-life care with complex symptom management

This list is not exhaustive. Anyone with complex, ongoing health needs is worth assessing. The NHS uses a structured tool called the Decision Support Tool (DST) to assess eligibility, which looks at care needs across twelve specific care domains.

How is eligibility assessed?

The process works like this.

Step 1: Checklist screening

A healthcare professional, usually a nurse, social worker or occupational therapist, carries out an initial checklist. This is a screening tool designed to identify whether a full assessment is warranted. Anyone can request a checklist assessment, including the person themselves, their family, or their GP.

If the checklist suggests CHC may apply, the process moves to a full assessment.

Step 2: Full multidisciplinary assessment

A team of healthcare professionals, typically including a nurse and a social worker, meets to complete the Decision Support Tool. The person receiving care and their family should be involved. The twelve domains assessed include:

• Behaviour
• Cognition
• Communication
• Psychological and emotional needs
• Mobility
• Nutrition and hydration
• Continence
• Skin and tissue viability
• Breathing
• Drug therapies and medication
• Seizures
• Altered states of consciousness

Each domain is rated as no need, low, moderate, high, severe or priority. A priority rating in any domain, or a combination of severe or high ratings across several domains, typically results in a recommendation for CHC.

Step 3: Decision by the Integrated Care Board

The assessment and recommendation are reviewed by the NHS Integrated Care Board (ICB) for your area, which makes the final funding decision. If CHC is approved, the ICB funds the care package.

What if CHC is refused?

CHC decisions can be disputed. If you believe the assessment was not carried out correctly, or that the decision does not reflect your family member's needs accurately, you have the right to request a review and, if necessary, an independent appeal.

The process can feel bureaucratic and slow, particularly when you are already dealing with a difficult situation. It helps to have clear records of the person's care needs, any clinical input from professionals involved in their care, and documentation of how needs have changed over time.

What is a Fast Track CHC assessment?

If a person is at the end of their life, or their condition has deteriorated to a point where care is urgently needed, a Fast Track CHC assessment can be requested. This is designed to cut through the standard timescale and put funding in place quickly, sometimes within 48 hours.

Any clinician can make a Fast Track referral. If someone you love is in this situation, it is worth asking the GP or palliative care team about this option as soon as possible.

How does CHC work alongside home care?

When CHC is approved for home care, the ICB funds a care package based on the assessed need. This might cover:

• Visiting care at set hours each day
• Live-in care with a dedicated carer
• Waking night cover
• Complex care delivered by carers with specialist training

The ICB will commission the care, either through a local authority framework or by agreeing a care package with a provider directly. Families can sometimes have a say in which provider is used, particularly if they have an existing relationship with a provider they trust.

Blossom Healthcare Solutions works with CHC-funded packages and is experienced in the coordination and clinical governance requirements that CHC places on providers. If you are going through the process and want to discuss care options, we are happy to talk.

Other funding routes worth knowing

CHC is the most significant funding option for people with primarily health-related needs. But there are others worth being aware of.

Local authority social care funding. If someone is assessed as having care needs and their savings and assets fall below £23,250 (England, 2025 threshold), they may qualify for means-tested support from their local council. A Care Needs Assessment through Essex County Council or Hertfordshire County Council is the starting point.

Attendance Allowance. A non-means-tested benefit for people over State Pension age who need help with personal care or supervision. It does not cover the cost of care directly but can contribute to it. In 2025 it is £72.65 per week (lower rate) or £108.55 per week (higher rate).

Personal Independence Payment (PIP). The equivalent benefit for people under State Pension age with a disability or long-term health condition.

Carer's Allowance. If you are an unpaid family carer providing 35 or more hours of care per week, you may be entitled to Carer's Allowance, currently £81.90 per week.

Where to start

If you think CHC might apply to someone you care for, the first step is to ask for a checklist assessment. You can request this through:

• The person's GP
• A hospital discharge team (particularly relevant if the person is currently in hospital)
• A social worker or care coordinator
• The NHS Integrated Care Board for your area (Hertfordshire and West Essex ICB if you are in our area)

You do not need a referral to ask. You simply need to ask.

If you would like to talk through the situation before approaching the NHS, Blossom Healthcare Solutions is happy to help.

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This article is for general information purposes only and does not constitute financial, legal, medical or professional advice. While we aim to keep content accurate and up to date, information may change over time and individual circumstances vary. Please seek independent professional advice before making any decisions based on this content.