NHS Continuing Healthcare: Could the NHS Pay for Your Care? (2026)

If someone's care needs are mainly about health rather than social support, the NHS may pay for all of it — in a care home, at home, or anywhere else. This is NHS Continuing Healthcare (CHC), and it's often missed because families aren't told it exists. This guide covers who qualifies, how the assessment works, and what to do if a claim is turned down.

What is NHS Continuing Healthcare?

NHS Continuing Healthcare is a package of care arranged and funded solely by the NHS for adults with ongoing health needs. Unlike social care, it isn't means-tested — your income, savings or property make no difference to whether you qualify.

CHC can be provided in a care home, in your own home, or in another setting. If you get full CHC in a care home, the NHS pays the whole fee, including the "hotel" costs of accommodation and meals, not just the nursing element.

This guide describes the system in England. Scotland, Wales and Northern Ireland run their own continuing care arrangements with different rules and thresholds, so check the position with your local NHS board or health authority if you live outside England.

Who qualifies for NHS Continuing Healthcare?

There's no list of qualifying conditions. Eligibility is based on the type and level of need, assessed against four characteristics:

• Nature — the type of need, and how it affects the person's daily life.
• Intensity — how severe the needs are, and how much support they require.
• Complexity — how difficult the needs are to manage, especially if several needs interact.
• Unpredictability — how likely needs are to change suddenly or become hard to control.

Someone can have a serious diagnosis — dementia, Parkinson's, a stroke, cancer — and still not qualify, if their day-to-day needs are stable and manageable through normal social care. Equally, someone without a dramatic diagnosis can qualify if their needs are complex and unpredictable enough. The NHS social care and support guide and Alzheimer's Society both have practical explanations of how this applies in dementia care specifically, where CHC is often wrongly assumed not to apply.

How does the CHC assessment work?

The process has four broad stages:

1. Checklist — a quick screening tool, usually completed by a nurse, social worker or discharge coordinator. It flags whether a full assessment is worth doing. Anyone involved in someone's care can ask for this to be started.
2. Full assessment (Decision Support Tool) — a multidisciplinary team, typically including nurses, social workers and sometimes GPs or therapists, scores needs across 12 domains: breathing, nutrition, continence, skin condition, mobility, communication, psychological and emotional needs, cognition, behaviour, drug therapies and medication, altered states of consciousness, and other significant needs.
3. Decision — the assessment team's recommendation goes to the local ICB, which makes the final eligibility decision.
4. Funding — if eligible, the NHS arranges and funds the care package in full, and reviews it periodically.

You, or the person being assessed, should be involved throughout. Ask to see the completed Checklist and Decision Support Tool, and request written reasons for the decision — you'll need these if you later want to challenge it.

Fast Track for end of life

If someone is nearing the end of life and their condition is deteriorating rapidly, a clinician can apply for the CHC Fast Track Pathway. This bypasses the full Checklist and DST process so that funding and care can be put in place quickly, often within days.

CHC vs Funded Nursing Care: what's the difference?

If someone doesn't meet the threshold for full CHC but lives in a nursing home, they may still qualify for NHS Funded Nursing Care (FNC) — a fixed weekly contribution towards the cost of the nursing care element of their fees, paid directly to the home. It's smaller than CHC, but it's still not means-tested.

The FNC rate changes each year — check the current weekly rate on GOV.UK or with your ICB rather than relying on a figure from an old article.

How do you get an assessment?

You can ask for a CHC Checklist to be completed by:

• A GP, hospital discharge team, community nurse, or social worker already involved in the person's care.
• Contacting the local ICB directly and requesting an assessment.
• Raising it as part of a wider care needs assessment with the local council, which should flag potential CHC eligibility.

There's no charge for requesting or undergoing an assessment, and no time limit on when you can ask — CHC needs can be assessed at hospital discharge, during a stay in a care home, or while someone is being cared for at home.

What if the claim is refused?

Refusals happen often, and they're not always right. If you disagree with a decision:

1. Ask in writing for the full reasons, including a copy of the completed Decision Support Tool.
2. Request local resolution — most ICBs have a formal review process for disputed decisions, usually with a set time limit to apply (commonly around six months).
3. If local resolution doesn't resolve it, you can ask for an Independent Review Panel, coordinated by NHS England, to look at the case.
4. Keep detailed records throughout — care diaries, GP letters, medication charts and behaviour logs all help build the case that needs are primarily health-related.

If a relative has died and you believe they should have received CHC funding while alive, you may be able to make a retrospective claim for a refund of care fees paid during that period. These claims have strict time limits, so act promptly and seek advice.

Does CHC eligibility last forever?

No. Eligibility is reviewed — usually after three months, then at least annually — because needs can change. A review can confirm continued funding, reduce it, or end it if needs have reduced. If funding is withdrawn, the person moves back to the local-authority means-tested system, and it's worth checking whether a financial assessment and care needs assessment are needed straight away to avoid a funding gap.

How does CHC affect other benefits and funding?

If CHC fully funds care in a care home, Attendance Allowance usually stops, since it's meant to help with care costs the NHS is now covering. If CHC funds care at home, Attendance Allowance may continue — check current rules with the Department for Work and Pensions or MoneyHelper. CHC has no effect on Pension Credit eligibility itself, but a change in income or care arrangements is always worth reviewing with a benefits check.

If the person lacks the mental capacity to manage their own affairs, having a registered lasting power of attorney in place makes it much easier for a family member to request assessments, see records, and pursue appeals on their behalf.