Continuing Healthcare

NHS continuing healthcare (CHC) is the name given to a package of services which is arranged and funded by the NHS for people outside hospital with ongoing health needs. You can get continuing healthcare in any setting, including your own home or in a care home.

NHS continuing healthcare is free, unlike help from social services for which a charge may be made depending on your income and savings. If you do not qualify for NHS Continuing healthcare you will still receive mainstream services free of charge i.e. GP, District Nursing Services, Specialist therapy – this is not to say that if you are awarded CHC you are still not entitled to NHS services free at the point of delivery. If NHS continuing healthcare is provided in a care home, it will cover the care home fees, including the cost of accommodation, personal care and healthcare costs.

Anyone assessed as requiring a certain level of care need, can get NHS continuing healthcare. It is not dependent on a particular disease, diagnosis or condition, or on who provides the care or where that care is provided. The circumstances can include:

• Older people with chronic illness or disabilities
• Older people suffering from mental illness or dementia
• People suffering from mental illness
• Physically disabled adults
• People with learning disabilities
• People who are terminally ill

If your overall care needs show that your primary need is a health one, you should qualify for continuing healthcare. The primary health needs should be assessed by looking at all your care needs and relating them to four key indicators.

• Nature – the type of condition or treatment required (quality and quantity)
• Complexity – symptoms that interact, therefore difficult to manage or control
• Intensity – one or more health needs, so severe they require regular intervention
• Unpredictability- unexpected changes in condition that are difficult to manage and present a risk to you or others.

Some people who are eligible for CHC choose to have a personal health budget so they can organise and manage their care themselves. Find out more on this page.

If you do not qualify for NHS continuing healthcare then you may have to pay for some or all of your care, although the NHS will still provide for your medical needs. You may have to take a local authority means test to decide how much you should pay towards your personal care and accommodation if you are in a care home.

If following assessment for NHS continuing healthcare you remain unsatisfied with the outcome you can appeal the decision by contacting the Retrospective and Appeals Team on 01603 257064 or writing to them at NHS Norfolk and Waveney CCG, Lakeside 400, Old Chapel Way, Broadland Business Park, Thorpe St Andrew, Norwich, NR7 0WG

Department of Health guidance can be consulted for a fuller account of the rules and duties of NHS bodies to provide NHS continuing healthcare.

• National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care: October 2018 (Revised) (published in March 2018): This is the version of the National Framework which will be in operation from October 2018.
• NHS Continuing healthcare: checklist from October 2018, (published March 2018)
• NHS Continuing Healthcare Decision Support Tool from October 2018 (published March 2018)
• Fast Track Pathway Tool for NHS Continuing Healthcare from October 2018, (published March 2018)
• NHS-funded nursing care best practice guidance (revised) (July 2013)
• National Framework for Children and Young Peoples Continuing Healthcare
• Delayed discharges directions (continuing care) directions (November 2013)
• Department of Health Public Information Leaflet: NHS Continuing Healthcare and NHS Funded Nursing Care (April 2013)
• NHS website: NHS Continuing Healthcare
• Beacon, Independent advice on the CHC process
• Age UK, Factsheet 20, NHS continuing healthcare and NHS-funded nursing care (October 2018)
• Alzheimer’s Society, When does the NHS pay for care? Guidance on eligibility for NHS continuing healthcare funding in England, (revised October 2017)