NHS Continuing Healthcare (CHC) funding: What families need to know

Working out how to pay for care is easily one of the most stressful parts of supporting a loved one. The funding system feels complicated, and it’s easy to get lost in the jargon.

NHS Continuing Healthcare (CHC) exists to relieve some of that strain. It is a fully funded NHS care package for individuals with complex health needs.

It isn’t means-tested, so savings and financial assets don’t affect eligibility. Here is a clear look at how it works and what your family needs to know.

What is NHS Continuing Healthcare (CHC) funding?

NHS Continuing Healthcare is care arranged and funded entirely by the NHS for adults whose main need for care is a health need.

It may cover the full cost of support, whether in a person’s own home or a care setting. Unlike social care, it is free at the point of use.

According to the House of Commons Library, 104,400 people in England received NHS Continuing Healthcare in 2021/22. Because it is fully funded, this kind of NHS funding for care may lift much of the financial pressure that comes with arranging complex care.

Who is eligible for NHS-funded nursing care?

Eligibility for CHC depends on a person’s assessed health needs, not their diagnosis or where they live. The key test is a “primary health need”, meaning their care needs are mainly about health rather than day-to-day social support.

Eligibility is not guaranteed, and rates vary widely. According to the Nuffield Trust, around 21% of people assessed through the standard route were found eligible in early 2024, ranging from 7.3% in one area to 42.5% in Leicester, Leicestershire and Rutland.

A person may qualify if they have complex, intense, or unpredictable needs across areas such as mobility, breathing, medication, or cognition.

It helps to know how the main funding routes differ:

How the CHC assessment process works

Getting CHC follows a set process, moving from a quick initial screening to a fuller assessment when needed. It is designed to build a clear picture of a person’s health needs before any funding decision is made.

The initial checklist

The process usually starts with a checklist. A nurse, doctor, or social worker works through it to decide whether a person’s needs are significant enough to move on to a full assessment.

Passing this stage does not mean funding is agreed. It simply opens the door to a closer look, and many people who complete the checklist go on to the next step.

The full assessment

A small team of health and social care professionals then carry out a full assessment. Their recommendation then goes to the local Integrated Care Board, which makes the final funding decision.

The aim is to see the whole person rather than a single condition, so the assessment weighs how needs combine and how unpredictable they are.

Areas the assessment may consider include:

• Breathing
• Mobility
• Communication
• Psychological and emotional needs
• Nutrition, eating, and drinking
• Continence and skin condition
• Behaviour and cognition

Keeping a short diary of daily needs beforehand may help these areas feel accurate on the day, especially where symptoms change from one hour to the next.

The fast-track pathway

For someone whose health is declining quickly, there is a faster route. A senior clinician may complete a fast-track assessment, so support can be arranged without delay, often within days. This pathway recognises that some families simply cannot wait for the standard timeline.

What NHS CHC funding may cover

If your loved one is found eligible, NHS Continuing Healthcare funding may cover the care needed to meet their assessed needs, at home or in a care setting. The exact support depends on the individual, so no two funded packages look quite the same.

Depending on the assessment, funded support may include:

• Personal care visits to help with washing, dressing, and daily routines
• Nursing input for clinical needs and medication
• Waking or sleeping night support
• Equipment that helps with comfort, mobility, and safety
• Specialist input for complex conditions

Because CHC follows a person’s assessed needs, the funded package may be reviewed and adjusted over time as those needs change.

How local authority funding can support care at home

When someone’s needs are mainly social rather than health-related, funding usually comes through the local council instead of the NHS.

This support is means-tested, so it depends on income and savings, and may include local authority funding for care in your own home as well as in a care home.

Funding for dementia care

Dementia is one area where funding often causes confusion. Much of dementia support is treated as social care, so families may face high costs.

According to the Alzheimer’s Society, people with dementia and their families shoulder around 63% of the total cost of dementia in the UK. Seeking advice early may help you understand what dementia care funding your family could access.

Complex care at home with Aspire UK

Once funding is in place, the next step is choosing care that fits your loved one’s needs.

Aspire UK, based in Leicester, provides specialist complex care at home across Leicester, Leicestershire, and the wider Midlands, working alongside NHS and local authority teams so support stays joined up.

Our complex care services support a wide range of conditions, including:

• Dementia care
• Post-stroke care
• Palliative care
• Multiple sclerosis care
• Motor neurone disease care
• Acquired brain injury care
• Spinal injury care
• Parkinson’s care
• Tracheostomy care

Whatever route funds the care, we can help you understand your options. You can find out more about paying for care by reaching out to our team at any time.

Common NHS funding for care questions

Is it hard to get CHC funding?

It can feel challenging, as eligibility rests on having a “primary health need” rather than a particular diagnosis, and not everyone assessed will qualify. Preparing well, keeping detailed notes on daily needs, and understanding the Decision Support Tool may help you feel more confident going in.

How long does it take to get a decision on CHC funding?

A full assessment following a positive checklist should usually be completed within 28 days. The fast-track route, for people whose health is declining quickly, is designed to reach a decision far sooner, often within days.

Can NHS Continuing Healthcare be used for care at home?

Yes. If someone is eligible, CHC may fund care in their own home, not only in a care home. This means a person may receive fully funded support in familiar surroundings, depending on their assessed needs.

Can you lose CHC funding?

Yes. Eligibility is normally reviewed after the first three months and then at least once a year, and funding may change if a person’s assessed needs reduce. If that happens, the local authority and NHS should work together so support continues smoothly.

What happens if we disagree with a CHC decision?

You have the right to ask for the decision to be reviewed. It often helps to keep detailed notes and request a copy of the Decision Support Tool used, so you can understand how the decision was reached.