Questions About NHS Continuing Healthcare Funding Answered
When families first hear about this care package, they often have questions about NHS Continuing Healthcare funding or CHC, as it is often called. They usually feel confused about what it is, who qualifies, and how to apply. The rules are complex and not widely understood, which means that many people miss out on vital support. To help you cut through the confusion, we have gathered the most common questions people ask about NHS Continuing Healthcare funding and provided clear, straightforward answers.
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What is NHS Continuing Healthcare funding?
NHS Continuing Healthcare funding is a package of care that is fully funded by the NHS for adults with long term, complex or severe health needs. It covers the full cost of care, whether the person lives in their own home, a nursing home, or a residential care home. Unlike social care, which is means tested, CHC is not based on income or savings. Instead, it depends entirely on the person’s health needs.
Who is eligible for NHS Continuing Healthcare funding?
Eligibility for CHC does not depend on having a particular diagnosis. Instead, the assessment looks at whether a person has what is called a “primary health need.” This means that their care needs are mainly for healthcare, rather than social care.
The decision is based on four main factors:
- The nature of the needs
- The intensity of the needs
- The complexity of the needs
- The unpredictability of the needs
These factors are considered across 12 domains, such as breathing, mobility, nutrition, behaviour, and psychological needs. A person may qualify if they have at least one priority need or severe needs in several domains. Alternatively, they may qualify because any of the four key characteristics mentioned above are identified.
How do you apply for NHS Continuing Healthcare funding?
The application begins with a Checklist assessment, which is a short screening tool completed by a healthcare or social care professional. If the checklist suggests that the person might be eligible, the case moves on to a full assessment using the Decision Support Tool (DST). This is carried out by a Multi Disciplinary Team, usually involving both health and social care professionals.
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You have the right to attend the assessment and provide evidence about your loved one’s care needs. The result should be provided in writing, with clear reasons given. In theory, the whole process should take 28 days, but in reality, it often takes longer.
What does NHS Continuing Healthcare funding cover?
CHC funding covers the entire cost of a person’s care package. This includes:
- Nursing and healthcare support
- Personal care such as washing, dressing and eating
- Residential or nursing home fees including accommodation and food
- Care provided in the person’s own home
Does NHS Continuing Healthcare funding cover dementia care?
Yes, a person with dementia can qualify for NHS Continuing Healthcare funding if their needs meet the criteria. The important point is that eligibility is based on health needs rather than the diagnosis itself. Many families are told that dementia care is always classed as social care and therefore means tested, but that is not correct. If dementia symptoms are severe, complex, or unpredictable, the person may qualify for CHC.
How long does NHS Continuing Healthcare funding last?
CHC is not necessarily a permanent award. Once someone qualifies, their care package is reviewed within the first three months and then at least once a year. If their needs have changed, funding may continue, increase, decrease, or in some cases stop altogether. This is why it is important to keep accurate records and be involved in the review process.
What if NHS Continuing Healthcare funding is refused?
If your application is refused following the DST, you have the right to appeal. The first step is to request a Local Resolution meeting with the Integrated Care Board (ICB). If the decision still stands, you can then ask for an Independent Review by NHS England. Families often find this stage difficult because of the amount of evidence required, but it is worth pursuing if you believe your loved one meets the criteria.
Can I claim NHS Continuing Healthcare funding retrospectively?
Yes. If a person has died or if you believe they were wrongly charged for care in the past, you can make a retrospective claim. This involves asking the NHS to review whether they should have been eligible for CHC during the relevant period. If successful, the estate may be entitled to a refund of the care fees that were paid. These claims can be lengthy and complex, so many families choose to seek professional advice before starting.
Check out our free retrospective claims calculator
Do I need a solicitor for NHS Continuing Healthcare funding?
You are not required to use a solicitor, but many families find it a relief to let a professional take the lead. The process is complex, and decisions can be unfair or inconsistent. A solicitor who specialises in CHC can help prepare evidence, attend assessments, and represent you in appeals. They can also advise on related issues such as Powers of Attorney, estate planning, and care home contracts. Having professional support can improve your chances of success and reduce stress at a difficult time.
Why is NHS Continuing Healthcare funding so important?
The cost of care can be extremely high, often exceeding £1,000 per week in a nursing home. Without CHC funding, families may have to use savings, sell property, or significantly change financial plans. For those who qualify, CHC ensures that care is provided without financial pressure. It also gives peace of mind that health needs will be met with the right level of support.
Still have questions about NHS Continuing Healthcare funding?
NHS Continuing Healthcare funding is a vital but often misunderstood entitlement. Knowing the answers to the most common questions can help you recognise when CHC should be considered and how to apply.
If you believe your loved one may be eligible, the most important step is to request an assessment and gather evidence of their health needs. Even if the first application is refused, do not give up. Reviews and appeals are a normal part of the process.
Our specialist team can guide you through every stage, from initial application to appeals and retrospective claims. We are here to help you secure the funding your loved one deserves.
Contact us today to find out more about how we can support your family.
