NHS Continuing Healthcare
What Is NHS Continuing Healthcare?
NHS Continuing Healthcare — CHC — is a package of ongoing care, fully funded by the NHS, for adults whose health needs are so complex that the NHS, not a local council, must take full responsibility. If your loved one qualifies, the NHS pays all care costs. Not a contribution — all of them.
The core distinction
The NHS and local councils split responsibility for care in England. Councils fund “social care” — help with daily tasks like washing, dressing, and eating. The NHS funds healthcare. In practice, this boundary is contested and poorly understood by families navigating the system.
CHC exists for people whose needs have crossed a threshold — where the nature, complexity, intensity, or unpredictability of their health needs means the NHS, not a council, must take full responsibility. The National Framework (July 2022) sets out how that threshold should be applied. In practice it is applied very inconsistently.
Approval rates vary from 3.4% to 57.9% across England's 42 Integrated Care Boards. The same patient, assessed in a different postcode, can receive a completely different outcome.
What does CHC cover?
If found eligible, the NHS arranges and pays for all of the following:
- All nursing home or residential care fees
- All healthcare delivered within that setting
- Equipment, therapies, and specialist clinical input
There is no means test. Assets and savings are not assessed. The person keeps their State Pension and any other income. The NHS covers care costs in full.
CHC can also be delivered at home. It is not limited to care home settings.
Who might be eligible?
CHC is not diagnosis-led — it is needs-led. There is no condition that automatically qualifies or disqualifies someone. The assessment considers the individual's actual presentation: the nature, complexity, intensity, and unpredictability of their needs.
Conditions that commonly give rise to CHC eligibility include Alzheimer's and other dementias, stroke, Parkinson's disease, multiple sclerosis, motor neurone disease, cancer, and acquired brain injuries — but the test is always applied to the specific person, not their diagnosis.
Why do so many families miss out?
Three reasons compound each other.
First, Integrated Care Boards have a direct financial incentive to find people ineligible. A single nursing home placement can cost the NHS £67,600 or more per year. Assessment decisions are not made in a vacuum.
Second, the assessment process is genuinely complex. The framework spans 12 care domains, applies a four-characteristic legal test, and is administered by a multidisciplinary team. Families are expected to navigate this at the most distressing time of their lives, often with no representation.
Third — and most common — families are simply never told CHC exists. Many spend years paying privately for care that the NHS should have funded, and only discover CHC retrospectively, if at all.
The check below takes three minutes and tells you whether your loved one's profile warrants a formal assessment request.
Frequently asked questions
Is CHC the same as NHS-funded nursing care?
No. NHS-funded nursing care (FNC) is a flat weekly contribution — £235.88 in 2024/25 — toward registered nursing costs in a nursing home. It is available to people who do not qualify for CHC but have nursing care needs. CHC is different: it covers all care costs in full.
Can someone claim CHC retrospectively?
Yes. The NHS operates a formal retrospective review process — known as PUPoC (previously unassessed periods of care). Families can challenge historic funding decisions going back years. Only around 424 retrospective claims succeed annually, but the average recovery is around £30,000. Our retrospective recovery guide explains how to start.
Can CHC be delivered at home?
Yes. If found eligible, the NHS should arrange care in the most appropriate setting — which can be the person's own home. The assessment determines eligibility; a separate care planning process then determines the setting.