NHS Continuing Healthcare: What It Is and How to Apply (2025)

NHS Continuing Healthcare (CHC) is one of the most significant — and most missed — sources of funding for people with serious health needs in England. If your family member qualifies, all of their care costs are fully funded by the NHS, including nursing home fees. No means testing. No asset assessment.

Yet most families never know to ask for it. This guide explains what it is, who qualifies, and how to navigate the assessment.

What exactly is NHS Continuing Healthcare?

CHC is a package of care, arranged and funded entirely by the NHS, for adults with a primary health need — meaning their care needs are predominantly driven by a health condition rather than social care needs.

If your family member qualifies, the NHS funds their care wherever they receive it: at home, in a care home, or in a nursing home. There is no means test — assets and income are irrelevant.

This is a substantial benefit. A nursing home in the UK can cost £40,000–80,000 per year. CHC covers that cost completely for eligible individuals.

Who qualifies?

There is no fixed diagnosis or condition that automatically qualifies someone. The assessment is based on the nature, intensity, complexity, and unpredictability of someone's needs — not their diagnosis.

People who commonly qualify include those with:

• Advanced dementia with significant behavioural or psychological symptoms
• Complex neurological conditions (MS, Parkinson's, MND)
• Stroke with severe residual disability
• Advanced cancer or other terminal illness
• Severe and complex mental health needs
• Conditions requiring frequent clinical intervention

Having one of these conditions does not guarantee eligibility — and not having them does not preclude it. The assessment looks at the whole person.

The two-stage assessment process

Stage 1: The Checklist

A nurse, social worker, or other health professional completes a CHC Checklist — a screening tool across 11 care domains. If the person meets the threshold, they proceed to a full assessment. If not, you can request a review.

The 11 domains assessed are:

Stage 2: The Full Multidisciplinary Team (MDT) Assessment

If the checklist is passed, a full assessment takes place — usually involving a nurse, social worker, and ideally the GP. Each domain is scored across levels: no needs, low, moderate, high, severe, or priority. A "primary health need" exists if the overall picture is dominated by health rather than social care needs.

The fast track pathway

If your family member has a rapidly deteriorating condition or is approaching end of life, there is a Fast Track CHC pathway. A clinician (usually the GP, consultant, or senior nurse) completes a Fast Track Tool and CHC funding can be approved within 48 hours. This is specifically designed for people who don't have time to wait for the standard process.

Ask the GP, hospital consultant, or palliative care team about fast track if time is critical.

What families get wrong

Accepting a negative decision without challenging it

CHC decisions are frequently contested — and frequently overturned on review. If your family member is declined, you have the right to request a local resolution meeting and then escalate to NHS England if still unsatisfied. Many families successfully appeal CHC decisions.

Not being present at the assessment

You have the right to be present. Bring evidence — a care diary, a list of incidents, letters from the GP or specialists. The assessment team sees a snapshot; you have the full picture.

Not requesting reassessment after hospital admission

If your family member has been in hospital and their condition has deteriorated, request a CHC reassessment before discharge. Hospital is a natural trigger point for reassessment.

Waiting to be offered it

CHC is rarely proactively offered. Families usually only access it because they asked. Ask the GP, the discharge nurse, or the social worker: "Has a CHC checklist been completed?"

If CHC isn't awarded: NHS Funded Nursing Care

If your family member lives in a care home that provides registered nursing care but doesn't qualify for full CHC, they may still be eligible for NHS Funded Nursing Care (FNC) — a flat-rate contribution toward nursing care costs (currently £235.88/week). This is separate from CHC and less comprehensive, but still worth accessing.

After approval: managing the package

Once CHC is approved, the Integrated Care Board (ICB, formerly CCG) becomes responsible for commissioning and funding the care. You can request that the funding be given as a Personal Health Budget — giving you more flexibility to choose and direct care.

CHC packages are reviewed regularly. If needs change — either increasing or decreasing — the package is reassessed. If your family member's needs increase, request a reassessment rather than waiting for a scheduled review.

This article is for general information only. NHS Continuing Healthcare eligibility is assessed individually. Consult NHS England, your GP, or a care specialist for advice specific to your situation.