NHS Continuing Healthcare — commonly referred to as NHS CHC — is a package of ongoing care funded entirely by the NHS for adults who live outside of hospital and have significant, complex, or unpredictable health needs. Unlike local authority social care funding, NHS CHC is not means-tested. Eligibility is determined solely by the nature and intensity of the individual’s health needs, not their finances.
Despite this, NHS CHC remains one of the least understood funding routes available to people in England. Many families only discover it exists after a loved one has been discharged from hospital, or after months of paying privately for care that could have been fully funded.
Who Is Eligible for NHS CHC?
Eligibility for NHS Continuing Healthcare is based on whether the individual has what is described as a “primary health need”. This is assessed using the NHS CHC Decision Support Tool, which considers the nature, intensity, complexity, and unpredictability of the person’s health needs across twelve care domains including behaviour, cognition, psychological and emotional needs, communication, mobility, nutrition, continence, skin integrity, breathing, drug therapies and medication, altered states of consciousness, and other significant care needs.
The key question is whether the individual’s needs are primarily health needs — in which case the NHS should fund them in full — or primarily social care needs, in which case the local authority takes the lead. In practice, many individuals sit in a grey area where both health and social needs are significant.
How Is the CHC Assessment Process Carried Out?
The NHS CHC process typically begins with a Checklist assessment, carried out by a healthcare professional such as a nurse, social worker, or therapist. If the Checklist indicates that the person may be eligible, a full Multi-Disciplinary Team (MDT) assessment is then arranged.
The MDT assessment is conducted by a panel including at least one nurse and one social worker, and considers the person’s full care needs across all twelve domains. The outcome is a recommendation — either that the person qualifies for full NHS CHC funding, partial joint NHS and local authority funding, or local authority funding alone.
The final decision rests with the local Integrated Care Board (ICB), which was formerly the Clinical Commissioning Group (CCG).
What Should Families Do If They Think Someone May Be Eligible?
• Ask the person’s GP, hospital consultant, or ward nurse to request a CHC Checklist assessment. This can be done at any point, not only at hospital discharge.
• Request the assessment in writing and keep a copy.
• Gather as much documentation as possible about the person’s health needs — GP letters, hospital discharge summaries, specialist reports.
• Consider attending the MDT assessment with the person if possible, and bring a written summary of their needs.
• If the outcome is negative and you believe the decision is wrong, you have the right to request a review and ultimately to appeal.
How Does Lamora Healthcare Support CHC Packages?
Lamora Healthcare is a CQC-registered, nurse-led complex care provider with experience delivering NHS Continuing Healthcare packages across Bedfordshire, Buckinghamshire, and Luton. Our clinical governance model — with nursing directors directly overseeing every package — meets the expectations of NHS commissioners for high-dependency CHC care.
We accept referrals from ICBs, hospital discharge teams, and case managers. For families whose loved ones are already in receipt of CHC funding and are seeking a specialist provider, we are happy to discuss whether we are the right fit.
This article was produced by the clinical team at Lamora Healthcare Ltd. It is intended for general information purposes and does not constitute clinical or legal advice. For guidance specific to your situation, please contact our team or speak to a qualified healthcare professional.