NHS Continuing Healthcare (CHC): Are You Eligible, and How Does It Work?

NHS Continuing Healthcare, usually shortened to CHC, is one of the most valuable — and most misunderstood — funding routes in the care system. Done properly, it can mean the NHS funds someone's entire care package, including social care elements that would otherwise be means-tested. But the process is notoriously confusing, and many eligible families never apply simply because they don't know it exists.

What Is NHS Continuing Healthcare?

CHC is a package of care that's arranged and funded solely by the NHS for individuals outside of hospital who have significant, ongoing healthcare needs. Unlike most social care, which is means-tested through your local authority, CHC funding isn't based on income or savings at all — it's based purely on the level of need.

Who Is Eligible?

Eligibility is assessed against a "primary health need" — essentially, whether someone's care needs are primarily health-related rather than social. This is judged across several factors:

• The nature and complexity of the health need
• The intensity and severity of needs
• Unpredictability — how likely needs are to change suddenly

There's no single diagnosis that automatically qualifies someone — eligibility is about the overall level and complexity of need, which is why the assessment process matters so much.

How Does the Assessment Process Work?

1. Initial checklist

A quick screening tool, usually completed by a nurse, social worker, or other healthcare professional, to determine whether a full assessment is warranted.

2. Full multidisciplinary assessment

If the checklist suggests eligibility might apply, a full assessment is carried out by a team of health and social care professionals, using a detailed decision support tool covering 12 care domains — from behaviour and cognition to mobility, medication, and skin condition.

3. Decision

The assessment findings go to a panel, who make the eligibility decision. If eligible, the NHS funds and coordinates the ongoing care package.

What If You're Refused?

CHC decisions can be appealed, and it's genuinely worth doing so if you believe an assessment didn't accurately reflect someone's needs — appeals succeed more often than many families realise, particularly when the original assessment was rushed or didn't fully capture fluctuating or complex needs.

What Happens If Someone Isn't Eligible for Full CHC?

There are related, more limited funding routes worth knowing about, including NHS-funded Nursing Care (a fixed contribution toward nursing costs in a care home) and joint funding arrangements between the NHS and local authority. A care provider or advocate experienced in this area can help you understand what actually applies to your situation.

A Practical Tip

Keep detailed records throughout — care notes, GP letters, hospital discharge summaries, anything documenting the person's needs over time. Assessments often rely heavily on written evidence, and gaps in the paper trail can genuinely affect the outcome, even when the underlying need is real.

How JJR Care Can Help

JJR Care is registered on the Pan-London NHS Continuing Healthcare AQP framework and regularly supports CHC-funded care packages across Essex and London. If you're navigating a CHC assessment, or have already been approved and need a provider in place, we're happy to help however we can.