NHS continuing healthcare: what is it and do I qualify for funding?

If you have ongoing complex health conditions, you could be eligible for ongoing NHS healthcare. If you are eligible, you could receive personal care at home, in a residential care home or in a hospital.

Here’s what you need to know about continuing healthcare.  

What is NHS continuing healthcare (CHC)? 

NHS CHC is a free service offering specialist care to adults with special care needs.

This continuing care can be carried out in a few different environments and is designed to ensure that adults with a disability, illness or who are suffering with the effects of an accident continue to receive the care they need.  

Who qualifies for NHS continuing healthcare? 

Eligibility for NHS CHC is decided over two assessments to be carried out by NHS professionals.

To be eligible for NHS CHC, you will need to be aged 18 or older and have a ‘primary health need’.

Your eligibility will be decided over the two assessments, and on the basis of a checklist that your assessors must follow to determine whether you are eligible.  

Some factors that assessors will use to decide if you have a primary health need are: 

• What assistance you require 
• How complex your needs are 
• How intense your condition or conditions can be
• How unpredictable the condition is, including the potential risks of you not receiving the right care 

What happens if you have eligibility for NHS continuing healthcare? 

If you are eligible for NHS CHC and would like to apply for continuing support, you will need to make an application.

You will first need to attend a screening interview that will usually be carried out in a hospital or at home by a nurse, doctor, social care worker or another professional.

Before moving on to a more detailed assessment, you will be assessed against a checklist. While having to prove your conditions may be frustrating, many of the individuals and families of those who have received the continuous care service continue to believe the benefits are worth it.  

The continuing healthcare checklist is an assessment of your general health and care needs, and will consider:  

• Mobility 
• Breathing 

• Continence 
• Communication 
• Nutrition 
• Skin – including wounds and ulcers 
• Psychological and emotional needs 

• Altered states of consciousness 
• Symptom control through drug therapies and medication 
• Cognition – everyday understanding of what’s going on around you 
• Other significant care needs 

Following your assessment, you should normally find out if you are eligible for continuing care within 28 days.  

What happens if you do not have eligibility for NHS continuing healthcare? 

If you are not eligible for NHS continuing healthcare, you may be entitled to other funding from your local authority or charities.

Depending on your assessment, you may be eligible for NHS Funded Nursing Care (NHS FNC).

While continuing care covers all of your specialist medical costs, FNC will see the NHS cover some of the costs of your specialist care if you live in a care home. This funding care is paid weekly to your care home and will go towards helping you receive the care you need.  

Alternatively, you could also be eligible for support from your local authority. You could be eligible for local council funding if you have savings less than £23,250. If you are eligible, the council may cover all or some of your costs.  

How do I get fast help for NHS continuing healthcare? 

If you need help urgently and don’t feel you can wait 28 days, for example if your health is deteriorating quickly or you have a terminal illness, you may be able to have a quicker assessment known as the Fast Track Pathway Tool.

A healthcare professional will decide if you need to be fast-tracked and will organise this for you. If you meet the criteria, you will usually be given NHS continuing healthcare within 48 hours. 

How does the continuing healthcare assessment work? 

When applying for continuing healthcare, most people will be assessed against the CHC checklist above. Then, depending on your medical circumstance, you may then be invited to attend a full assessment or a fast-track assessment. 

A full assessment is led by a multidisciplinary team (MDT) made up of a minimum of two healthcare professionals. If possible, the MDT will include health and social care professionals who have already been helping to care for you.

The team will make a more in-depth assessment of your needs, taking into account your condition and significant care needs. Your needs will be assessed as ‘priority’, ‘severe’, ‘high’, ‘moderate’, ‘low’ or ‘no needs’.

If you have at least one priority need, severe needs in at least two areas, or a priority need as well as a number of high needs, you will likely be eligible for NHS CHC. 

If your health is deteriorating quickly and you need care quickly, you could be prioritised for a fast-track assessment. A GP, registrar or registered nurse familiar with your needs will be able to complete this fast-track assessment, which aims to get funding for care in place within 48 hours. 

What will the NHS continuing healthcare be like? 

The care you receive will be tailored around your own needs, and you will be consulted about the kind of care you want to have. 

You might have care workers appointed for you, or you might receive a personal health budget to spend on your choice of care (as long as it meets the needs highlighted in your assessment). Alternatively you may be looked after in a residential care home local to you. 

The care or funding you are offered is known as your ‘care and support package’. This package should be reviewed within the first three months and then annually to ensure that it still covers all your needs.  

Is there NHS continuing healthcare for children with illnesses or disabilities? 

NHS CHC can only be accessed by adults. Children and young people under 18 can access a similar service called Continuing Care, but once they turn 18, they must be reassessed for adult CHC

The continuing care package takes into account different services that are available to children through the NHS and local authority. Once you turn 18, you must be reassessed for the adult form of NHS continuing healthcare. 

Get financial advice

NHS continuing healthcare provides crucial support for individuals with complex health needs and ensures they receive appropriate care tailored to their specific conditions.

Whether you're navigating the assessment process, seeking alternative funding options, or exploring care packages, understanding your eligibility and the available support can make a significant difference.

If you or a loved one might qualify, it’s essential to stay informed and seek guidance to secure the care needed. For those facing urgent health situations, the Fast Track Pathway can expedite support and ensure timely and compassionate care.

Unbiased will match you with a financial adviser for experienced financial advice on managing care costs, exploring funding options, and planning for future healthcare needs.