This is any past period where the NHS didn’t check if someone was eligible for Continuing Healthcare. If that happened, you may be able to reclaim care fees.

It is a concept developed by the Department of Health and Social Care to assist in the determination of eligibility for NHS Continuing Healthcare. According to the National Framework for Continuing Healthcare Funding and NHS-funded Nursing Care, the Nature, Intensity, Complexity, and/or Unpredictability of your needs may indicate a Primary Health Need.

This is the first step in appealing a CHC funding refusal. It’s a chance to meet with the NHS Integrated Care Board (ICB) and challenge their decision before going to an Independent Review Panel.

It’s a care package fully funded by the NHS for people with serious ongoing health needs. It covers care home fees, nursing care, and support at home.

CHC is a fully funded healthcare package provided by Integrated Care Boards on behalf of the NHS for individuals who are assessed as having a Primary Health Need due to significant, ongoing healthcare needs.

FNC is a financial contribution by the Integrated Care Board towards the cost of care and the cost of nursing care for those in a nursing home. It is an acknowledgement that you have nursing needs, but that they are incidental to your social care need. Unlike Continuing Healthcare Funding, which pays 100% of the care costs of those people who are assessed as having a Primary Health Need.

Data from NHS England shows that only around 13% to 25% of appeals are overturned at Local Dispute Resolution. This data will include appeals brought by a variety of people. It’s really important to get realistic advice about your prospects, and to ensure the appeals process is fully exhausted to Independent Review Panel, where there is merit in doing so. Success will also depend on how well your case is presented.

The Checklist is the first step in the CHC process. It’s a screening tool used to decide if a full assessment is needed. Many cases fail here, but we help you prepare.

CHC is for people with significant healthcare needs, whereas local authority funding is typically for social care needs and may involve a means test.

Someone such as a nurse or social worker will complete the Department of Health and Social Care’s NHS Checklist tool to screen the individual’s needs, determining whether a full eligibility assessment is needed. If it is, then a multi-disciplinary team (MDT), best comprising a combination of health and social care professionals, will complete the Decision Support Tool (DST) to obtain further information about the individual’s needs, before making a recommendation to the Integrated Care Board about their eligibility.

You’ll usually need the Decision Support Tool (DST), outcome letter, and any meeting notes or reports. You may also wish to obtain clinical or witness evidence. Here at Winston Solicitors, we will guide you on what’s needed at every stage.

Charities can provide free information, and for more direct help, organisations. Or law firms, such as Winston Solicitors, can help you.

Local Dispute Resolution happens with your local NHS team. If that doesn’t resolve things, you can ask NHS England to set up an Independent Review Panel.

The earlier the better. Getting advice right after the ineligibility decision can improve your chances and reduce delays. But we can help at any stage.

Anyone who has care needs which go beyond what a local authority social services department can provide may be eligible for CHC. Assessors will apply the “Primary Health Need” test to help determine this.

CHC Solicitors are fully regulated professionals with legal expertise, insurance, and a duty to act in your best interests. Unlike unregulated claims companies, we’re accountable to the Solicitors Regulation Authority and can provide tailored legal advice, strategic representation, and transparent pricing. If you only need help with a specific part of the process, we’ll give you a bespoke estimate. No hidden fees and no one-size-fits-all approach.