NHS continuing healthcare (NHSCHC) is the name given to a package of care that is arranged and funded solely by the NHS for individuals who are not in hospital and have been assessed as having a “primary health need”.

If you or a member of your family is eligible, NHSCHC can be received in a variety of settings, for example

  • in the home – the NHS will pay for healthcare, such as services from a community nurse or specialist therapist, and personal care, such as help with bathing, dressing and laundry
  • in a care home – as well as healthcare and personal care, the NHS will pay for care home fees, including board and accommodation.

NHSCHC is free at the point of delivery, unlike social and community care services provided by local authorities for which you or your family member may be charged, depending on income and savings.

To be eligible for NHSCHC you or your family member must be over 18 and have substantial and ongoing care needs. You or they must have been assessed as having a primary health need.

Eligibility for NHS continuing healthcare does not depend on a specific health condition, illness or diagnosis, who provides the care, or where the care is provided.

Assessment for NHSCHC can take place in either a hospital, before discharge back home or to a care home, or non-hospital setting. The first step is usually the screening process which involves the completion of a NHSCHC checklist by a suitable qualified healthcare or social care professional. This will determine whether or not a full assessment for NHSCHC eligibility is considered necessary. If it is, then the local Clinical Commissioning Group (CCG) has responsibility to co-ordinate a comprehensive multidisciplinary assessment, which includes the completion of a decision support tool.

It is also possible for retrospective claims to be brought for unassessed periods of care (after 1 April 2012) by the individual, their attorney or deputy, or their executors following death.

We can help you or a family member with the claim or if it has already been denied, either at the initial screening process or by the CCG following completion of the multidisciplinary assessment, to challenge the decision.

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