NHS Continuing Healthcare (NHS CHC) is a package of care arranged and funded by the NHS for adults whose needs are mainly about health rather than everyday personal care. If someone qualifies, their care is fully funded and free, and it is not means-tested, whatever their savings.
The catch is that the bar is high and the assessment is complex. It is still worth understanding, because for the right person it changes everything.
- What NHS CHC is, and who it is for
- How it differs from paying for your own care
- How the assessment works, in plain terms
- What to do if you are turned down
What NHS CHC is
If your loved one is eligible, the NHS pays for all of their care to meet their assessed needs, whether that is care at home or in a care home, including the accommodation part of a care-home fee. It is based on the person's needs, not their diagnosis or condition.
How it differs from self-funding
Self-funding is means-tested: above £23,250 in savings you pay in full, as set out in my savings thresholds and means testing guide. NHS CHC is the opposite: free and NHS-funded, regardless of savings or income.
There is also a middle option, NHS-funded nursing care, a flat weekly amount the NHS pays towards nursing in a care home for people who need it but do not qualify for full CHC.
Who might qualify
Eligibility turns on a 'primary health need', judged from the nature, intensity, complexity and unpredictability of someone's needs. People with advanced, complex or rapidly changing conditions are the most likely to qualify. Many people with high needs are not eligible, so go in hopeful but realistic.
How the assessment works
- A short Checklist screening, done by a nurse, doctor or social worker, decides whether to go further.
- If it passes, a full assessment by a multidisciplinary team uses the Decision Support Tool to weigh the needs and recommend a decision.
- For someone deteriorating rapidly or nearing the end of life, a Fast Track route skips the checklist and tool and puts care in place quickly, usually within 48 hours.
You can ask for an assessment, and you can bring someone with you. Free support is available from an advocate or a specialist adviser.
If you are turned down
Many CHC decisions are refused first time. You have the right to ask for the decision to be reviewed, and then to appeal beyond that. Keep copies of assessments and care records, and get help from Age UK or a specialist CHC adviser, because the process is detailed and the paperwork matters.
Sources
General guidance for England. NHS CHC rules and the assessment tools are set nationally but applied locally, so check the current NHS guidance for your area. Last reviewed: July 2026.
