NHS Continuing Healthcare Eligibility

NHS Continuing Healthcare is the most important funding stream most families have never heard of. If your parent qualifies, the NHS pays 100% of their care costs — including accommodation, food, personal care, and nursing. No means test. No £23,250 capital threshold. No contribution from your parent's savings or property.

The catch: getting through the assessment process, which is designed to screen people out rather than screen them in.

What CHC Actually Covers

CHC is a complete package of care arranged and funded by the NHS for adults with a "primary health need." Eligibility is based solely on the nature, intensity, complexity, and unpredictability of the person's health needs — not their income, savings, or property.

If CHC is granted, it replaces local authority funding entirely. The NHS pays the full cost of wherever your parent receives care, whether that's at home, in a care home, or in a nursing home.

The Two-Stage Assessment

Stage 1: The Checklist Screening

A nurse, GP, or social worker completes the initial CHC Checklist, which screens across 11 care domains. A full assessment is triggered if the screening identifies:

• At least two domains rated "A" (severe or high need), or
• Five or more domains rated "B" (moderate need), or
• One "A" plus four "B" ratings

If the checklist doesn't hit these thresholds, it normally does not trigger a full assessment. The family can ask the ICB to reconsider a negative checklist result. The checklist can be requested by anyone involved in the person's care, including family members. You do not have to wait for a professional to initiate it.

Stage 2: The Decision Support Tool (DST)

A multidisciplinary team (MDT) evaluates the individual across 12 care domains: cognition, behaviour, communication, psychological and emotional needs, mobility, nutrition, continence, skin and tissue viability, breathing, drug therapies and medication: symptom control, altered states of consciousness, and other significant care needs.

The MDT then applies four key characteristics to assess whether the overall pattern of needs amounts to a primary health need:

• Nature — the type of clinical needs and what specialist skills are required
• Intensity — how much care is needed and how consistently
• Complexity — how different conditions interact and create risks that are harder to manage
• Unpredictability — how rapidly the condition can change, requiring immediate clinical intervention

No single domain or characteristic is decisive. The assessment looks at the overall picture. A parent with severe dementia might score moderately in several domains rather than severely in one — the interaction between those needs is what can tip the assessment toward a primary health need finding.

Why Most Families Fail the First Time

The initial assessment often underscores needs because it captures a snapshot rather than the full picture. A parent assessed during a stable period looks very different from the same parent during a crisis, a sundowning episode, or an infection-related delirium.

Families can improve their chances by:

• Keeping a daily care diary in the weeks before the assessment, documenting episodes of confusion, falls, behavioural changes, and interventions required
• Attending the MDT meeting — a Health and Welfare LPA gives you the legal standing to participate, access clinical records, and advocate for your parent
• Challenging domain scores during the meeting if they don't reflect the daily reality

What Happens If CHC Is Denied

If the MDT decides your parent doesn't have a primary health need, you can appeal. The process escalates through three levels:

1. Local resolution with the Integrated Care Board (ICB) — essentially asking them to reconsider the evidence
2. Independent Review Panel — convened by NHS England, with independent clinical and lay members reviewing the decision
3. Parliamentary and Health Service Ombudsman — for cases where the process itself was flawed

The appeal window is typically within six months of the decision, though families can request a review at any time if the person's condition has materially changed.

NHS-Funded Nursing Care (The Partial Alternative)

If your parent doesn't qualify for full CHC but needs registered nursing care in a care home, the NHS pays a flat-rate contribution directly to the care home through NHS-funded Nursing Care (FNC). The standard rate from April 2026 is £267.68 per week — a meaningful offset against nursing home fees that can exceed £1,400 per week.

FNC doesn't cover personal care, accommodation, or food. It covers only the nursing element. The ICB assesses eligibility, often using the CHC assessment; a separate nursing-needs assessment may be arranged if necessary.

The England Lasting Power of Attorney & Deputyship Kit includes a CHC preparation framework with the domain-by-domain notes template and the documentation strategy that gives your family the best chance of getting through the assessment.

See more England guides →