A Step-by-Step Introduction for Families Wondering How to Apply for NHS Continuing Healthcare Funding
Applying for NHS Continuing Healthcare (CHC) can feel like trying to navigate a maze. Especially when you're already under emotional strain. But knowing how to apply for NHS Continuing Healthcare Funding could make all the difference for your loved one’s care and your family’s peace of mind.
To discuss applying for NHS CHC call 0113 320 5000
We work with families every day who are facing this exact challenge. Whether you’ve just started wondering if CHC might apply, or you’ve been passed between professionals without clear answers, this guide is here to walk you through the full process.
What Is NHS Continuing Healthcare Funding?
Before you even start looking into how to apply for NHS Continuing Healthcare Funding, it’s important to understand what it actually is.
NHS Continuing Healthcare is a package of care that’s fully funded by the NHS. It’s available for adults with long-term, complex, or unpredictable health needs. CHC covers 100% of care costs, whether at home or in a care home. Crucially, it’s based on health needs, not finances or specific diagnoses.
This funding can be life-changing for families. However, many people miss out due to misunderstandings or problems with the assessment process. That’s why knowing how to apply for NHS Continuing Healthcare Funding properly is so important.
Step 1: Know What CHC Covers and Who’s Eligible
Understanding eligibility is the foundation of any CHC application. To be eligible, your loved one must have what's called a “primary health need.” Meaning that their care is required mainly for health reasons, not just personal or social care.
The NHS looks at four key indicators to decide this:
- Nature – the type of care needed
- Intensity – how severe or frequent the needs are
- Complexity – how the needs interact, making them difficult to manage
- Unpredictability – how likely things are to change or deteriorate
Eligibility is assessed across 12 care domains, such as breathing, mobility, cognition, and nutrition to name a few. Needs are graded from "no needs" to "priority." You don’t need a specific diagnosis. Rather, it’s about how those needs present and what care is needed to meet the needs.
If your loved one qualifies, CHC funding will cover:
- Nursing and healthcare from trained professionals
- Personal care (e.g., washing, dressing)
- Full care home fees, including accommodation and meals
- Home-based care, if appropriate
This funding is not means-tested, and there are no "top-up" payments required. Which can be a huge financial relief for many families.
Step 2: Start with the CHC Checklist
The first formal step in how to apply for NHS Continuing Healthcare Funding is the NHS Checklist. This is a quick screening tool designed to flag whether someone should move forward to a full assessment.
You can ask any trained health or social care professional, such as a nurse, doctor, or social worker, to carry out the Checklist. If you're told your loved one "won't qualify," but you believe otherwise, don’t stop there. Contact your local Integrated Care Board (ICB), who have a legal duty to arrange assessments when needed.
Before the assessment, it’s helpful to:
- Gather any care records or letters from the ICB
- Prepare a list of questions
- Familiarise yourself with the CHC criteria
During the Checklist, needs across the 12 domains are scored as A, B, or C (A being the highest). The threshold is deliberately set low to ensure people who might qualify aren’t missed.
Checklist outcomes:
Positive >>> moves forward to full assessment
Negative >>> full assessment of eligibility is not required
You must be told the outcome in writing.
Message the CHC team at @email
Step 3: The Full Assessment - What to Expect
If your Checklist is positive, the next part of how to apply for NHS Continuing Healthcare Funding is the Decision Support Tool (DST) assessment. The DST takes a more detailed look at your loved one’s care needs.
This is done by a Multi-Disciplinary Team (MDT), which must include at least two professionals from different backgrounds (usually health and social care). You or your representative have the right to attend and your input is valuable.
- How to prepare for the DST:
- Gather full care plans, medical records, and incident logs
- Ask care providers to document recent events (like falls or seizures)
- Keep a diary of physical and emotional wellbeing
- Review the CHC domain criteria so you know what to expect
Each domain will again be graded, and eligibility usually requires either:
- One priority level need, or
- Severe needs in at least two areas, or
- The existence of one or more of the four key indicators (i.e. nature, intensity, complexity and unpredictability.
The MDT must complete all parts of the DST and then make its recommendation on eligibility to the ICB. Once the assessment is done, you should receive a written outcome explaining the decision.
Step 4: What Happens Next?
If you are approved, then your loved one will have their care fully funded by the NHS. The existing care package may stay exactly as it is, or the ICB may make recommendations. Options might include:
- Receiving care at home
- A care home placement
- A personal health budget for more flexibility
Reviews should be focussed on ensuring that the care package is still appropriate to meet need and usually take place at 3 months and then annually to check if needs have changed.
If you have been refused, you can appeal. Appealing is often worth doing, especially if you feel the assessment didn’t reflect the true picture.
There are two appeal stages:
- Local Resolution – within 6 months of the decision
- Independent Review – within 6 months of the ICB’s final decision following Local Resolution.
If you’d like support with an appeal, a solicitor can be extremely helpful, particularly if the case is complex, or you want to ensure your arguments are correctly presented. Our CHC team can assist with appeals, gather evidence, draft arguments, and attend assessments as your advocate.
When to Get Legal Help
If you’re unsure how to apply for NHS Continuing Healthcare Funding, or you’re stuck in the process, we can help. Our experienced team offers advice on eligibility and support with Checklist and DST preparation. We can also represent you at assessments and appeals and offer help with retrospective claims, if care was paid for when it should have been fully funded by the NHS due to health needs.
Despite what some professionals or organisations may imply about legal representation, you absolutely can have a solicitor represent you at any stage of the process – legal representation is a right. We’re here to ensure your loved one gets the care they deserve and that your voice is heard.
Contact the CHC team on 0113 320 5000
Knowing how to apply for NHS Continuing Healthcare Funding can help you unlock essential support at a time when your family needs it most. It’s not always a straightforward journey, delays are common. That's why understanding the process it key. It gives you the power to advocate confidently and effectively.
If you’d like personalised advice or help with any stage of your application, our CHC team is here to support you every step of the way.
