NHS Continuing Healthcare (CHC)
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NHS Continuing Healthcare (CHC) & Funded Nursing Care (FNC) – An Overview
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NHS Continuing Healthcare (CHC) is a package of care that is fully funded by the NHS for individuals whose primary need is a health need rather than a social care need.
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Unlike local authority funding, CHC is not means tested. This means that eligibility is based solely upon the nature, intensity, complexity and unpredictability of a person's healthcare needs—not upon their income, savings or the value of their home.
Where a person qualifies, the NHS will normally meet the full cost of their assessed care needs, whether they are living:
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in a care home;
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in a nursing home;
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in their own home; or
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in another appropriate care setting.
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Where someone does not qualify for full NHS Continuing Healthcare but does require the services of a registered nurse, they may instead qualify for NHS-funded Nursing Care (FNC).
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This is a contribution made by the NHS towards the nursing element of care home fees.
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Although FNC does not cover the entire cost of care, it can still represent a significant financial benefit and should always be considered where nursing care is required.
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Expert Support with NHS Care Funding Claims
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Paying for long-term care can place an enormous financial burden on individuals and their families. However, many people who are paying for care should, in fact, be receiving funding from the NHS.
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At CHC Legal, we help families understand the complex NHS Continuing Healthcare (CHC) and NHS-funded Nursing Care (FNC) systems, guide them through the assessment process, and challenge decisions where appropriate.
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If you or a loved one has significant health needs, it is important not to assume that paying care home fees is the only option.
Who May Be Eligible?
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Eligibility is determined through a detailed assessment carried out by the NHS.
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Many people assume that only those with terminal illnesses qualify, but this is not the case.
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Conditions that may give rise to eligibility include:
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advanced dementia;
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Parkinson's disease;
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stroke;
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multiple sclerosis;
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severe physical disabilities;
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neurological conditions;
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complex behavioural needs;
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profound learning disabilities;
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serious mental health conditions; and
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any combination of medical conditions resulting in significant healthcare needs.
Every case is assessed on its own facts.
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If you or a loved one has significant health needs, it is important not to assume that paying care home fees is the only option.
The Assessment Process
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Obtaining NHS funding can be challenging.
The assessment process involves several stages and requires detailed evidence about an individual's healthcare needs.
Typically, the process includes:
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an initial Checklist assessment;
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a full assessment using the Decision Support Tool (DST);
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consideration by the Integrated Care Board (ICB); and
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a formal eligibility decision.
Many families find the process confusing and difficult to navigate without assistance.
How CHC Legal Can Help
We understand how stressful it can be to deal with complex funding assessments while also supporting a loved one through illness or disability.
Our service can include:
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explaining the CHC and FNC eligibility criteria;
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reviewing medical and care records;
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helping you prepare for assessments;
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assisting with evidence gathering;
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representing your interests throughout the process;
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preparing written submissions where appropriate;
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challenging incorrect decisions; and
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advising on the available appeal procedures.
We aim to present your case clearly, professionally and with the supporting evidence necessary to give it the strongest possible prospect of success.
Why Many People Miss Out
Unfortunately, many individuals who may be entitled to NHS funding never receive it.
This can happen because:
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assessments are not requested;
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important medical evidence is overlooked;
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healthcare needs are underestimated;
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the assessment process is misunderstood; or
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families are unaware that decisions can be challenged.
Obtaining experienced support can often make the process considerably easier and ensure that all relevant evidence is properly presented.
Frequently Asked Questions
Is CHC means tested?
No. Eligibility is based entirely on healthcare needs and not on income, savings or property.
Can I apply if my relative already lives in a care home?
Yes. Many applications are made after someone has already entered residential or nursing care.
Can a negative decision be appealed?
Yes. If you believe the assessment or decision was incorrect, there are established review and appeal procedures.
How long does the process take?
Timescales vary depending on the complexity of the case and NHS workloads. Some cases are resolved relatively quickly, while others may require a detailed review or appeal.
Speak to CHC Legal
If you believe that you or a member of your family may be entitled to NHS Continuing Healthcare or NHS-funded Nursing Care, we are here to help.
We can explain the assessment process, discuss your circumstances, and advise on the most appropriate next steps.
Contact CHC Legal today for an initial discussion and find out whether NHS funding may be available.
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