NHS Continuing Healthcare

NHS Continuing Care is funding provided by the NHS for people in full time care

Elderly people and NHS Continuing HealthcareIt’s for people who are assessed as having a ‘Primary Health Need’.

NHS Continuing Healthcare is also known as ‘Continuing Care’ or ‘Fully Funded NHS Care’.

Over the last 3-4 years we have been contacted by over 1,000 families needing help navigating the Continuing Healthcare funding system. Many have never been told about NHS funding by the health and social care authorities, and yet the NHS has a duty to promote this funding.

Listen to the BBC’s File on 4 programme: ‘Continuing Healthcare – The Secret Fund’, broadcast on 18/11/14. It highlights some of the problems families experience in the funding assessment process.

What does NHS Continuing Care cover?

It covers 100% of care fees for people who need full-time care primarily for health reasons, i.e. they have a Primary Health Need. It’s available whether you’re in a care home, in your own home, in a hospice or somewhere else.

  • If you’re in a care home, NHS Continuing Healthcare covers all care fees, including the costs of accommodation.
  • If you’re receiving full time care at home, Continuing Healthcare covers all nursing care plus personal care (bathing, dressing, etc.) plus any household costs directly related to care needs.

It doesn’t matter whether you’re in a residential home or a nursing home, the same rules apply: It’s about your health needs first, not where you live or how much money you have.

The landmark Coughlan case, reinforced the difference between health needs and social care needs.

Should you be assessed?

If you have healthcare needs and you need full-time care, you should have a Continuing Healthcare assessment. NHS guidelines and the Standing Rules Regulations require local Clinical Commissioning Groups (formerly Primary Care Trusts) to assess anyone who appears potentially eligible for Continuing Healthcare.

However, many people find that they are assessed first by the local authority, to test their financial means.

If your local authority does a means test before you’ve been assessed for NHS Continuing Care, it can put the local authority in a potential unlawful position. Why? Because your care needs could be beyond the local authority’s legal remit for providing care, and you could end up wrongly paying. A Continuing Healthcare assessment needs to be carried out to clarify who is actually responsible for paying.

Many people with health and nursing care needs are automatically means tested first, and end up paying, and yet families report there will often have been no assessment for Continuing Healthcare. It is this that has led to thousands of retrospective claims for Continuing Healthcare being made.

What is the ‘National Framework’?

Prior to 2007 each Health Authority had its own eligibility criteria for Continuing Healthcare. The result was a ‘postcode lottery’, great confusion and thousands of complaints to the Health Service Ombudsman.

In 2007 the Department of Health introduced a new ‘National Framework’ for England, with the aim of providing a consistent single assessment process for everyone. Most (but not all) of these National Framework guidelines apply to Wales as well.

This National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care defines NHS Continuing Healthcare as follows:

“‘NHS continuing healthcare means a package of ongoing care that is arranged and funded solely by the NHS where the individual has been found to have a ‘primary health need’… Such care is provided to an individual aged 18 or over to meet needs that have arisen as a result of disability, accident or illness. …Eligibility for NHS continuing healthcare places no limits on the settings in which the package of support can be offered or on the type of service delivery.”

Get assessed for Continuing Care.

Read these frequently asked questions about NHS Continuing Healthcare – we’ve included lots of tips to help you.

How to get through a Continuing Healthcare assessment

Care To Be Different was set up by Angela Sherman, after she won a tortuous four-year battle to secure Continuing Healthcare funding for both of her parents. Since then she has had personal contact with over 900 families needing help understanding Continuing Healthcare. Almost all of those families had either not been told about NHS funding when a relative first needed nursing care and/or faced obstacles in the assessment process.Angela Sherman, Director, Care To Be Different

ctbd-books-pay-for-care-newAngela has written a book, How To Get The NHS To Pay For Care, to help families get through Continuing Healthcare assessments and argue their case. It shows you what to do – and what not to do – and it can save you losing everything in care fees. It’s easy to follow and cuts through the confusion to show you step by step how things work.

“We were so grateful to find a clear and helpful guide to the process at a time when my mum was so vulnerable. It gave our family the confidence to successfully fight for NHS funding. The NHS should be ashamed of the way families/carers are treated: incorrect records, withholding information, conflicting information… I felt I must write to thank you for the information.” Rachel

“We have heard today that my mother-in-law is to receive NHS Continuing Care funding. We could not have done it without your book and website. Thank you so much.” Ian Johnson

Read more about this e-book


  1. David sherriff 1 month ago

    Can I claim PIP if I am getting NHS continuing care? I am at home not in a nursing home.

    • Author
      Angela Sherman 4 weeks ago

      I suspect not, David, but I’m not 100% sure. You may find more here: https://www.moneyadviceservice.org.uk/en/categories/paying-for-care

    • Judy 2 weeks ago

      The answer to this is yes. PIP is to do with your disability and how it affects your everyday living. NHS Continuing Healthcare is to do with the NHS continuing to meet your healthcare costs wherever you might be.

  2. My mother was placed in a care home by the Social Services, and as such she has to pay all of her pension to stay there. I am, and was not aware of the Hospital funding No PaY Scheme. Is it possible to transfer to it? Mother nor I were given a choice of Home. She has Dementia, and I was put onto a “vulnerable” list, and left there. I flounder along surrounded by brick walls, and now have no say in her care at all.

    • Author
      Angela Sherman 3 weeks ago

      Jacqueline – Remember that it doesn’t matter whether or not your mother was placed in the care home by Social Services. That does not affect her entitlement to Continuing Healthcare (CHC). The only thing that matters when looking at a person’s eligibility for CHC is their health and care needs. Their money, the type of home, who placed them there, etc – these are all irrelevant. If you mean Continuing Healthcare when you say ‘hospital funding no pay scheme’, then yes, your mother should be assessed for this to determine whether or not she does have to pay for her care.

  3. claire 3 weeks ago

    Can you please tell if continual care package covers for full time care for a person in there own home I.e throughout the night also?

    • P J Nichols 2 weeks ago

      See my note above. My husband’s package of Continuing Healthcare allows 4 visits from carers daily. Apparently there is a facility for overnight care but this means the carer requires overnight accommodation. Otherwise I assume it means a residential nursing home.

    • Author
      Angela Sherman 1 week ago

      Yes, Continuing Healthcare funding is not dependent on where the care is provided; it can be in a care home or in a person’s own home.

  4. P J Nichols 2 weeks ago

    My husband is being nursed at home with Continuing Healthcare under a local hospice for end stage heart failure. He is normally looked after by me with the aid of carers and the district nurses. He recently spent a week in a local nursing home for respite care. We chose the nursing home from a list given to us by the Hospice. He had a standard room and the cost for the 7 nights was £1200, which is pretty much the norm for all the care homes on the list in our area. We chose it because it offers what he needed in terms of nursing care and was relatively easy for me to get to. We were told we would have to pay top up fees of £500, which we did. I now question whether we should have paid this top up fee but am confused by the legislation regarding when top up fees should be paid by someone having 100% funding from the NHS. Can anyone help?

    • Author
      Angela Sherman 1 week ago

      Top up fees apply to local authority care (social care) only. This is different to Continuing Healthcare. If your husband receives Continuing Healthcare, this funding should cover ALL assessed care needs, i.e. everything he requires for all his care needs. For more on top up fees: http://caretobedifferent.co.uk/care-home-top-up-fees/ Continuing Healthcare cannot be topped up. It is up to the care home to complain to the NHS if the NHS has not paid them enough.

  5. Sandra Williams 2 weeks ago

    My mum has full nursing care. How many weeks respite a year is she entitled to?

  6. Elaine Sloggett 7 days ago

    My father was sectioned under the mental health act earlier this year due to the continued decline in his dementia/alzhiemers. After the assessment period it was deemed that he more than met the criteria for CHC and we were given a list of homes available. We picked the home most suitable which was also recommended by the hospital staff as being the best for dad’s needs, dad moved in April. In May we were asked to attend a review by CHC. They deemed that he no longer required CHC funding as he appeared to have settled down (dispite there still being documented evidence of violent outburst) we were told the fees would be paid for by Social Services. Although we disagreed with their report, we were told that it was just a case of which pot the money came from and so we proceeded to get all paperwork to them for dad whilst having to then sort mum out mums financial details to get her Pension Credits, as they are now taking all of dads pension and work pension to pay towards his care. We have just been hit with another bomb shell to say that Social Services will only pay a certain amount of the fees as the care home is a specialist dementia home and more expensive than others and asked if we (the family) could pay the difference in cost for the home. My mother has move from a rented 3 bedroom house (family home for over 50 years) to a 2 bedroom so that she can afford the rent as the County Council pay an allowance based on occupancy. She is 82 and the stress is unbearable. What can we do? Dad is still prone to violent outbursts, is doubly incontinent and has to be fed and monitored 24/7. We feel this should fall under CHC, can you offer any suggestions please.

  7. g.gillson 2 days ago

    I live in powys wales what are the differences btween England and Wales.

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