NHS Continuing Healthcare
(CHC)
NHS Continuing Healthcare is a package of ongoing care arranged and funded solely by the NHS for adults outside hospital who have a complex medical or health need that is primarily health-related. Eligibility is determined by a multi-disciplinary team using a nationally standardised assessment framework, not by diagnosis or condition. If eligible, all care costs (including accommodation in a care home) are funded by the NHS; there is no means test.
The NHS CHC assessment follows the National Framework for NHS Continuing Healthcare (last revised 2022). A multi-disciplinary team (MDT) first completes a Checklist screening tool; those who meet the threshold proceed to a full assessment using the Decision Support Tool (DST), which scores needs across 12 care domains. A person is eligible if they have a 'primary health need' — determined by the nature, intensity, complexity, or unpredictability of their needs. Eligibility is not linked to a diagnosis, setting of care, or what care costs. Integrated Care Boards (ICBs) are responsible for CHC in England. Families can request a review if they disagree with a decision and have the right to an independent review by NHS England. Retrospective reviews can be requested for past periods of care, subject to a 12-year limitation period.