Continuing Care Advice

What Is NHS Continuing Healthcare?

NHS Continuing Healthcare is a package of care arranged and funded entirely by the NHS for adults aged 18 or over who are assessed as having a primary health need. Eligibility depends on the nature, complexity, intensity and unpredictability of the person's assessed needs, rather than simply their diagnosis, age or level of disability.

NHS Continuing Healthcare enables people to receive the support they need to maintain or improve their quality of life. Unlike short-term rehabilitation services (such as intermediate care), CHC is provided when ongoing, substantial health and care needs are identified.

NHS Continuing Healthcare is provided free of charge for people aged 18 or over who are are assessed as being eligible. It can be arranged in a variety of settings, including your own home, a hospital, hospice or care home.

If someone in a care home gets NHS Continuing Healthcare, it will cover their care home fees, including the cost of accommodation, personal care and healthcare costs. If NHS Continuing Healthcare is provided in the home of the person you look after, it will cover personal care and healthcare costs. It may also include support for you as a carer.

Continuing Healthcare may be offered for prolonged periods but not necessarily for life, so a patient's entitlement will be reviewed at regular intervals.

Children and young people under 18 may be eligible for a similar type of provisions, called Children and Young Peples Continuing Care. This is organised differently, under its own national framework. See the Children and Young People's Continuing Care national framework at www.gov.uk.

The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care sets out the national principles, processes and tools used to assess eligibility for NHS Continuing Healthcare and NHS-funded Nursing Care in England.

The revised National Framework was published in July 2022 and subsequently corrected in 2023. It provides a standardised approach to assessment and decision-making across England.

The national assessment process includes the NHS Continuing Healthcare Checklist, the Decision Support Tool (DST) and, where appropriate, the Fast Track Pathway Tool. These tools help determine whether a person's assessed needs demonstrate a primary health need and whether they should be eligible for NHS Continuing Healthcare.

Where a person is not eligible for NHS Continuing Healthcare but is assessed as requiring nursing care in a nursing home, they may instead be eligible for NHS-funded Nursing Care (FNC). FNC is different from NHS Continuing Healthcare: it is an NHS contribution towards the cost of nursing care provided by a registered nurse in a nursing home, rather than full NHS funding of the person's care package.

The NHS-funded Nursing Care contribution is set nationally. The standard rate applicable from 1 April 2026 is £267.68 per week, paid by the NHS directly to the nursing home.

Who is eligible for NHS Continuing Healthcare?

You must be aged 18 or over. Eligibility is based on an assessment of your health and care needs and whether you have a ’primary health need’. You do not need to have a particular diagnosis or condition to qualify.

NHS Continuing Healthcare is usually for people with long-term illnesses, disabilities, or complex conditions that are unlikely to improve quickly. It is not normally provided for shortterm or temporary needs, such as recovery from a routine operation.

NHS Continuing Healthcare is free of charge to people who are assessed as eligible. The NHS covers the cost of the care package in full, whether provided in your own home, a care home, hospice, or other setting. People may still choose to pay for additional non-essential services (such as higher accommodation standards), but the care itself is NHS-funded.

In England, local authorities can charge for other types of communitybased social care services (such as home help or respite care) if they are not covered by NHS Continuing Healthcare.

You can read more about NHS Continuing Healthcare on the NHS website at www.nhs.uk.

Who decides about NHS Continuing Healthcare?

A multidisciplinary team (MDT) of health and social care professionals will assess your needs and complete the Decision Support Tool. The MDT will make a recommendation about eligibility, and the Integrated Care Board (ICB) makes the eligibility decision.

Among these may be your GP, nursing staff, physiotherapists and social care professionals. This team will discuss with you and your family how the eligibility decision was reached as well as how, when and where the NHS Continuing Healthcare is to be provided. Your hospital will explain the procedure for discharge and for ongoing healthcare thereafter.

If you need both health and social care, a joint package of care may be arranged, with responsibilities shared between the NHS and the local authority. Staff should explain which aspects of your care will be NHS funded and which may be subject to means-tested social care charges.

The overall assessment and eligibility decision-making process should, in most cases, take no more than 28 calendar days from the date the ICB receives the positive Checklist or other notification of potential eligibility.

Patients have the right to ask for a review of any decision made by the team - especially about discharge from hospital. If you have concerns about your hospital care or discharge, you can ask the hospital’s Patient Advice and Liaison Service (PALS) for advice.

While you are in Hospital

The prospect of a stay in hospital can be daunting if you are not used to it. To help allay any fears that you may have, it is wise to make sure that you understand your illness.

They say knowledge is power and, in these terms, a better understanding of your condition will help you feel more in control and less anxious.

When in doubt, ask questions and you will find that your consultant, doctor or nurse will take the trouble to explain the reasons for their diagnosis. Likewise, be sure you understand why you are receiving certain medication or what undergoing a particular treatment will entail.

Discharge from Hospital

Where it has been assessed that you do not require ongoing NHS Continuing Healthcare you do not have the right to occupy an NHS hospital bed indefinitely. You should be involved in decisions about your discharge and where you will receive care. If there are concerns about your ability to make decisions about your care or accommodation, the relevant legal safeguards, including the Mental Capacity Act, should be followed.

If you do have concerns about being discharged from hospital and your right to Continuing Healthcare, you may wish to seek support and advice from the Patient Advice and Liaison Service (PALS) - ask a member of staff in the hospital for details of the local PALS office; there should be one in the hospital itself.

Discharge to a Care Home

Where you have been assessed as needing care in a care home - either arranged by your local authority or privately - you can choose the home you wish to go to, subject to it being suitable and affordable with the funding arrangements.

In England all care homes are registered and regulated by the Care Quality Commission (CQC). Different care standards authorities apply in Wales and Scotland.

Ongoing Support for Mental Health and Learning Disabilities

In England, approximately 1.3 million people are defined as having learning disabilities including 950,000 adults aged 18 and over.

As many as one in four of us are likely to experience mental health issues, such as depression or anxiety each year and a further one in every 100 experience severe mental illness, which may include a temporary period where they lose touch with reality.

Under the framework for NHS Continuing Healthcare, your mental, emotional and psychological needs will be assessed alongside the assessment of your physical or nursing care needs before you are discharged from hospital. If you do have learning disabilities or mental health needs, a care plan should be drawn up and overseen by a care co-ordinator who will help you access support from within your local community and various services.

There are a number of agencies throughout the UK that specialise in providing home help for people with primary health needs related to mental health or learning disability. You should ask your local authority what is available in your area. As ever, the Internet is an excellent source of information.