If you or someone you love has long-term, complex health needs, you might think the only route to meeting care needs is by selling your home or depleting your savings. That isn’t always true. NHS Continuing Healthcare (CHC) is a fully NHS-funded care package available to adults whose health needs exceed a set threshold, and unlike most social care support, it is not means-tested.
You may have heard the term used interchangeably with CHC funding or seen it referred to simply as NHS Continuing Healthcare (CHC). Regardless of the label, it represents care that is planned, arranged and paid entirely by the NHS, whether that care takes place in your home or somewhere else.
The guide takes you through what NHS Continuing Healthcare is, who is eligible for it, the checklist and full assessment process, how much CHC funding is actually worth, and how to apply.
We will also look specifically at how CHC funding can be used to pay for live-in care at home rather than a move into residential care and what your options are if an application is turned down.
Key Takeaways
NHS Continuing Healthcare (CHC) is a package of care fully funded by the NHS for individuals with a primary health need.
The NHS Continuing Healthcare (CHC) is not means-tested.
Eligibility depends on the nature, intensity, complexity and unpredictability of your needs, not on a specific diagnosis.
The process has two stages: an initial CHC checklist, followed (if you pass) by a full assessment using the Decision Support Tool (DST).
CHC funding has no fixed weekly rate; it covers the full, individually assessed cost of your care, which can include live-in care at home.
A Personal Health Budget (PHB) is the default way CHC funding is delivered in England and can be paid as a Direct Payment, so you can arrange live-in care yourself.
If you are refused CHC, you may still qualify for NHS-Funded Nursing Care (FNC) or a joint funding package with your local council, and you also have the right to appeal.
CHC funding is reviewed regularly (at 3 months, then at least annually) and can change if your needs change.
NHS Continuing Healthcare works differently across the UK: England, Wales, Scotland, and Northern Ireland each apply their own rules and terminology.
Use ComparedExperts to find the top live-in care providers that will help you with your funding needs.
What Is NHS Continuing Healthcare (CHC)?
NHS Continuing Healthcare (CHC) is a long-term care approach arranged and funded only by the NHS for adults with complex health needs.
Depending on your eligibility, CHC pays for all the care you need at home, including personal care, nursing care, and, where applicable, accommodation costs, regardless of how much income or savings you have.
One key point about CHC funding is that your eligibility for care is based purely on your assessed health needs, not on your money, property, or specific illness.
Also, two individuals with the same condition can have vastly different outcomes, because what matters is not the label but the level and often pattern of need.
CHC can be provided in different places away from the hospital, including your home, a care home, or a hospice. If you are deemed to have some health needs but do not meet the full CHC threshold, the NHS may still pay for some of your care as a joint package, with the rest funded by your local council.
One-Sentence Definition Of CHC Funding
NHS Continuing Healthcare (CHC) is a fully funded package of care for adults whose health needs are so complex, intense, or unpredictable that they qualify for a primary health need in an appropriate setting, including your own home.
Who Can Get NHS Continuing Healthcare (CHC)?
NHS Continuing Healthcare (CHC) is available to adults and is assessed by a multidisciplinary team that looks at your care needs across a wide range of areas.
Children and young people with similar complex health needs would instead receive a continuing care package through a separate related process.
Your diagnosis does not determine whether you qualify; it is your assessed needs that count. Your assessment focuses on four things:
- What help do you need?
- How complex are your needs?
- How intense can your needs be?
- How unpredictable are they, and is there a health risk if you do not receive timely, appropriate care?
A diagnosis such as dementia, Parkinson’s, motor neurone disease, or a stroke does not automatically qualify someone for CHC funding, and it does not rule someone out either. What matters is whether the resulting needs amount to what’s known as a primary health need.
Want to learn about dementia care funding? Read the ComparedExperts detailed guide on funding options for dementia care.
Primary Health Needs vs. Social Care Needs
It is important to be clear about the difference that the NHS draws between the two:
- Principal Health Need: Either for ongoing supervision of a condition, unstable symptoms, or some kind of specialist clinical intervention. CHC funding is for these patients.
- Social Care Needs: Assistance with day-to-day activities, such as washing, dressing, and making meals. That’s typically arranged and subject to means-testing by your local council.
In practice, the majority of patients who are assessed for CHC will have both. The assessment answers the question of whether the health-related needs are significant enough to offset the social care element.
The Criteria For CHC Funding: Explained
So when you search for the criteria for CHC funding, these are the four things that assessors will look at to see if your needs constitute a primary health need.
They are taken straight from the National Framework for NHS Continuing Healthcare, and every assessment revolves around them.
The four CHC criteria are as follows:
- Nature: What kind of need it is and what it will require in terms of care (for example, which needs are suitable or need specialist clinical management versus more general support).
- Intensity: The severity of the need and its demand for care relative to both quantity and quality.
- Complexity: How hard is the need to have/overcome? Do multiple needs overlap or mask each other?
- Unpredictability: How easy it can change or become unstable without warning, and what risk that creates if the appropriate care is not in place.
Assessors consider these four criteria together with evidence from risk assessments and the views of you, your family, and your carers. On its own, no single criterion automatically gives you eligibility: it is the cumulative picture across all your assessed needs that will determine if you are eligible.
NHS Continuing Healthcare CHC Checklist: How It Works
For most people, the CHC journey starts with a checklist. This is a screening tool used to decide whether you should go forward for a full assessment; it isn’t a decision on funding itself.
Who Completes The Checklist?
The checklist can be completed by a nurse, doctor, other clinician, or social worker. Typically, when you’re being discharged from the hospital, you are referred to your GP because of health problems or following a request from you and a family member. You should be informed when assessed and what the assessment includes.
What Does The Checklist Cover?
The checklist looks at your needs across a set of care domains, including breathing, nutrition, continence, skin integrity, mobility, communication, psychological and emotional needs, cognition, behaviour, drug therapies, medication, and altered state of consciousness. Each domain is scored, with some carrying more weight than others.
What Happens After The Checklist?
The passing score on the checklist is intentionally low; it does not determine if someone qualifies, only whether they should be considered.
If you pass, you’ll be referred for a full assessment. If you do not, they will inform you that you are ineligible for a full assessment and refer you to your relevant council to discuss social care support.
You have a right to a written copy of this checklist when the work is done and a statement explaining the decision. A blank copy of the NHS continuing healthcare checklist is downloadable from GOV.UK.
CHC Funding Criteria: The Full Assessment and Decision Support Tool
If you pass the checklist, the next step is an assessment by a multi-disciplinary team (MDT), typically at least two trained professionals from different healthcare fields, usually including people already involved in your care.
The MDT completes its report using the Decision Support Tool (DST), scoring each care domain as no needs, low, moderate, high, severe, or priority.
Of the twelve care domains, only four can be scored at the highest ‘priority’ level: behaviour, breathing, drug therapies (symptom control), and altered states of consciousness. A single ‘priority’ score in any one of these usually establishes a primary health need on its own.
The General Rule of Thumb
- Generally, a common indicative pattern is that you can be entitled to CHC funding if you have priority needs or severe needs in at least two domains.
- You may meet the criteria if you have one primary cause of need and two or more other causes of need, or if you have two high- or medium needs based on their collective nature, frequency, and severity.
Eligibility should generally be determined within 28 days of a checklist or request for a full assessment. You can be refunded for your care costs from day 29 if the NHS deems you eligible, but it took longer than 28 days to confirm, and the delay was caused by the organisation.
Fast-Track Assessments
The fast-track pathway is offered to those people whose health is deteriorating rapidly and who are potentially entering the final stages of their life. This completely bypasses the normal assessment process so that funding and support can be arranged, if necessary, within 48 hours.
How Much Is CHC Per Week?
This is one of the most common questions families ask, and the honest answer is: there is no fixed weekly rate for CHC funding. Unlike NHS-Funded Nursing Care (FNC), which pays a flat rate per person, CHC funding is calculated individually based on your assessed needs and the cost of meeting them in full.
In practice, that means CHC funding can cover costs that would otherwise run into hundreds or even over a thousand pounds a week, including nursing care, personal care, equipment, and accommodation costs where a care home is the right setting. There is no cap and no requirement to contribute from your savings or income.
As CHC funding is assessed according to your needs, the amount you are told you need can also change over time, upwards if your needs increase and downwards if they decrease, which is why the system includes regular reviews.
CHC has no set rate, but here is a useful comparator:
Even if you are not entitled to the entire CHC, you may be able to get some level of NHS-funded nursing care (FNC) at a set weekly rate if you require care from a registered nurse.
The FNC standard rate payable in England increased from £254.06 to £267.68 a week (+5.4%), and the higher rate increased from £349.50 to £368.24 a week for a few historical long-time recipients since 1 April 2026.
FNC is a useful reference point, but it isn’t a substitute for CHC: it only ever contributes towards nursing costs in a care home, whereas CHC can fund your entire package of care, wherever it’s delivered.
How To Apply For NHS Continuing Healthcare (CHC) Funding: Step-by-Step Process
Anyone can ask for an assessment; you do not have to wait for someone like a professional to recommend CHC. It could be yourself, a family member, or a carer who asks for an assessment if you think it is necessary to obtain.
Here is how it generally works:
- Request an Assessment: Request a CHC checklist from your GP, discharge team at the hospital, district nurse, or social workers. You can also contact your local Integrated Care Board (ICB).
- Complete the Checklist: The first screening checklist is done by a healthcare professional on all care domains. It should be made clear to you that you are being assessed and what the process actually entails.
- Wait for the Checklist Outcome: Feedback will tell you that you don’t qualify for a full assessment or that you’ll be taken through.
- Full Assessment (Decision Support Tool): This comprehensive assessment is usually undertaken within 28 days by a multidisciplinary team that uses the guidance to score you in every domain.
- Receive the Eligibility Decision: You will receive a written notice of the outcome, with reasons for it and a copy of the completed DST.
- Care and Support Planning: If you are eligible, the NHS works with you to agree on a package of support that meets your assessed needs, which may include talking about whether a Personal Health Budget would work for you.
- Ongoing Reviews: When a decision is made about CHC funding, it is periodically reviewed (the legislation requires such reviews to be done within three months after an initial decision, then at a minimum annually) to ensure your package still meets your needs.
Your views, and those of any carers or family members, must be included in the process, and you should stay fully informed and engaged.
Using CHC to Fund Live-In Care At Home
One of the most important but least understood facets of NHS Continuing Healthcare is that a care home placement is not required. CHC means that someone with complex health needs can remain at home and receive round-the-clock support in surroundings they are familiar with, provided that such care can be done safely.
Your Integrated Care Board (ICB) should work in partnership with you to agree your care and support package, taking into account not only what is important to you but also practical factors such as cost-effectiveness.
If living with paid live-in care is going to be your preference when the time comes, and those needs can safely be met at home, it should form a serious consideration rather than an afterthought.
Direct Payment For Live-In Care:
Of the three ways a Personal Health Budget can be administered (explained below), a Direct Payment gives you the most control if your goal is live-in care at home. It lets you choose your own live-in care provider directly, rather than having the NHS or a third party select one on your behalf.
What we like: you retain continuity of carer, choice over who comes into the home, and flexibility to adjust the arrangement as needs change, all while the funding itself remains fully NHS-provided.
What Is a Personal Health Budget?
Personal health budgets (PHB) are the most common way of delivering CHC funding in England, and they have been the default option for everyone receiving NHS Continuing Healthcare since April 2019.
PHB is not a bonus on top of your entitlement; rather, it’s a way of giving your agreed care budget a clear, transparent monetary value, so you have visibility and choice over how it is spent.
PHBs can be given in three different ways:
- Direct Payment: The NHS pays you or your representative a set sum of money for your care, and you choose and control your own care providers, including organising a live-in care service by yourself.
- Notional Budget: The NHS retains the funds but organises and pays your provider(s) according to your stated preferences.
- Third-Party Arrangement (TPA): An independent party, such as a trust or specialist broker, administers the funds and coordination of care on your behalf in accordance with your agreed care plan.
If you want to remain at home with a particular live-in carer or agency, a direct payment is often the best option by allowing you to create and manage that arrangement yourself, rather than relying on the NHS or other third party.
What If You Are Turned Down By CHC?
If CHC funding is refused either at the checklist stage or after a full assessment, it does not mean that you have no further options. You have several options:
NHS-Funded Nursing Care (FNC)
If your needs are more than what is required to qualify for the CHC but still require a registered nurse in a care home, you will normally be entitled to NHS FNC instead.
FNC provides you with an NHS payment (a set amount per week) towards the nursing part of your care home fees.
Want to learn about care home funding? Read our detailed guide on the funding options available for care homes.
Joint Funding Packages
If you have some health needs, but not to the level that is deemed a primary health need under CHC, the NHS may pay part of your support as a joint package, with the other part organised by your local council.
Appeals
You can contest or disagree with a decision. The National Framework outlines a straightforward appeals path:
- Ask for the DST or checklist paperwork and examine the assessors’ rationale against your own evidence.
- Collect supporting material such as GP records, care logs, and specialist reports that show the extent or unpredictability of the needs in question.
- Request a local resolution and a meeting with your Integrated Care Board to discuss the disputed decision.
- If not resolved, escalate to NHS England for the Independent Review Panel.
You usually have six months to request a local appeal, starting the day you were notified of a decision. You also ought to be aware that needs change: if the original decision was a tight-run thing, or events have moved on since then, a new application can sometimes succeed where an appeal of the original would fail.
Limitations Of NHS Continuing Healthcare (CHC) Funding
CHC funding is powerful, but it is important to go in with realistic expectations. A few limitations are worth understanding upfront:
- It isn’t permanent by default. Funding is reviewed within three months of the first award, then at least once a year, and it can be decreased or withdrawn if your circumstances change.
- You can’t supplement it with your own cash (like local authority-funded care). The only additional method of adding private services on top is paying separately for extra care performed by different staff, usually in a separate location.
- Assessment results may differ from region to region. Both the decline in national eligibility rates and the variation between Integrated Care Boards in how consistently they adhere to criteria are part of the reason why approach, evidence, and preparation are so important.
- The process is prolonged and paperwork-heavy, especially at the full assessment stage, and checklist referrals do not guarantee outcomes.
None of this should be off-putting if you feel the needs are there, but it is worth knowing what to expect and why keeping good records of those needs strengthens your application.
NHS Funding Across The UK
NHS Continuing Healthcare is an England-specific concept, and while the basic need for free nursing care for a health condition holds across the UK, the system, jargon, and rates differ in each nation.
England
- Managed by a National Framework for NHS Continuing Healthcare and delivered by Integrated Care Boards (ICBs).
- This process is guided by the Checklist, Decision Support Tool (DST), and Fast Track Pathway Tool.
- Personal Health Budgets, including Direct Payments, are available across the country, allowing families considerable freedom in arranging for live-in care.
Wales
- CHC in Wales operates similarly to England under the Welsh Government’s National Framework, using an equivalent checklist and Decision Support Tools structure.
- There is often a strong emphasis on joint packages, where the NHS and local authorities share costs if a full CHC isn’t granted.
- The NHS-funded nursing care equivalent rate in Wales is £201.74 per week.
Scotland
- Scotland replaced the traditional CHC model in 2015 with Hospital-Based Complex Clinical Care (HBCCC), which applies within a hospital setting.
- There is no CHC scheme by that name for home or care home settings. However, Scotland provides free personal and nursing care to those assessed as needing it, funded by the local authority and NHS.
Northern Ireland
- In Northern Ireland, continuing healthcare funding is available, but eligibility is extremely narrow. The system is governed by the integrated Health and Social Care trusts.
- You should contact your local Health and Social Care Trust for advice on funding for complex care needs.
Find The Top Live-In Care Providers With ComparedExperts
Securing CHC funding is only half the journey; the next step is finding a live-in care provider you can trust to help you with your funding needs.
At ComparedExperts, we help you compare live-in care providers across the UK so you can see costs, credentials, and care approaches side by side and make the right choice for your loved one’s needs.
Want to find the top live-in care provider? Just fill in our quick quote form, and we will connect you with the top live-in care providers near you.
FAQs
NHS Continuing Healthcare (CHC) is a package of care that is fully arranged and funded by the NHS for adults with long-term, complex health needs. It is not means-tested, and can be provided at home, in a care home, or in a hospice.
Eligibility depends on your assessed health needs rather than a specific diagnosis. Assessors consider the nature, intensity, complexity and unpredictability of your needs to decide whether you have a primary health need.
There is no fixed weekly rate for CHC. The funding is calculated individually to cover the full cost of your assessed care needs. This differs from NHS-Funded Nursing Care (FNC), which pays a fixed rate of £267.68 (standard) or £368.24 (higher) per week in England as of 1 April 2026.
You, a family member, or a healthcare professional can request a CHC checklist from your GP, hospital discharge team, or local Integrated Care Board. If you pass the checklist, a full assessment using the Decision Support Tools follows, usually within 28 days.
Yes. CHC funding can be used to arrange live-in care at home rather than a move into a care home, provided your assessed needs can be safely met there. This is most commonly arranged through a Personal Health Budget paid as a direct payment.
