Quick summary
If the main reason someone needs care is a health need rather than an age-related or social one, the NHS may pay for all of it, at home or in a care home. It is not means-tested and there is no contribution. Ask for a Checklist. The threshold is high and most applications are unsuccessful, which is not a reason to skip it.
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What is NHS Continuing Healthcare?
A package of care arranged and funded entirely by the NHS for adults assessed as having a primary health need.
Age UK describes it as covering, where care is delivered at home, the cost of the care and support needed to meet assessed health and associated care needs, including personal care such as help with washing and dressing. In a care home, the NHS pays the fees (Age UK).
The word that decides everything is “primary”. Not whether someone has health needs, but whether health needs are the main reason they need care at all. Local Integrated Care Boards commission it, and eligibility is not based on having any particular diagnosis.
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Why does nobody mention it?
Because the people families talk to most are usually not the people who hold it.
A council social worker assesses social care needs. Continuing Healthcare sits with the NHS. A family being means-tested for council funding may never hear that a non-means-tested NHS route exists, and nobody is obliged to raise it unless someone spots that it might apply.
The practical consequence: families with savings above £23,250 are told they will pay for everything, which is true for social care and may not be true here.
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How does the assessment work?
Two stages:
Stage one is the Checklist. A screening tool completed by a health or social care professional. It is deliberately generous, designed to filter people through to a full assessment rather than to decide anything. A GP, hospital team or the Integrated Care Board can complete it, and you can ask for one directly.
Stage two is the full assessment, carried out by a multidisciplinary team using the Decision Support Tool. It scores needs across twelve care domains, from no needs up to priority.
The NHS states that if you have at least one priority need, or severe needs in at least two areas, you can usually expect to be eligible. Integrated Care Boards should normally decide within 28 days of a completed Checklist or request for full assessment, and if an eligible decision takes longer than that without justification, care costs should be refunded from the 29th day (NHS).
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What counts as a primary health need?
It is assessed against four characteristics of the needs, rather than against a diagnosis.
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Characteristic | The question behind it |
|---|---|
Nature | What kind of needs are these, and what kind of help do they require |
Intensity | How severe are they, and how much support do they need, including continuity |
Complexity | How do the needs interact, and does managing them require skilled judgement |
Unpredictability | How much do they fluctuate, and what happens if care is not delivered promptly |
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In plain terms: if keeping someone safe day to day requires clinical judgement and skilled intervention rather than routine help, that points towards a primary health need. If it requires reliable, kind, ordinary support, it points towards social care.
One common trap is that needs that are well managed are still needs. If a condition looks stable only because it is being carefully controlled, that should be assessed on the underlying need, not on the calm surface.
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The challenge
Most people who apply are not found eligible. The threshold is genuinely high, the process is long, and it is emotionally draining at a point when families often have nothing spare.
Two things are still true. It is worth asking if health needs are complex, intense or unpredictable, because the cost of asking is a Checklist and the value if it succeeds is the entire cost of care. And a refusal is not the end: the decision letter must explain how to challenge it, and you can ask for reconsideration, then an independent review.
What is not worth doing is paying a company a percentage of any award to run a claim, before you have at least asked for a Checklist yourself and taken free advice from Age UK.
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Fast track
Where someone has a rapidly deteriorating condition that may be entering a terminal phase, a Fast Track Pathway Tool can be completed by an appropriate clinician, and funding should be put in place urgently rather than through the full assessment process.
If a clinician has raised end of life care, ask specifically whether a fast track application is appropriate.
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What if we are turned down?
- Get the decision in writing, with the Decision Support Tool scores and the reasoning.
- Check the evidence used. Disagreements often turn on a domain scored from a snapshot rather than from the full picture.
- Ask the Integrated Care Board to reconsider, then request an independent review if you are still unhappy.
- Ask for a local authority care needs assessment in parallel, so that a social care route is running while the health one is disputed.
- Get free advice. Age UK publishes a detailed factsheet on Continuing Healthcare and NHS-funded nursing care.
If someone is not eligible for Continuing Healthcare but needs nursing care in a nursing home, NHS-funded nursing care pays a flat contribution towards the registered nursing element. It is a different and much smaller thing, and it is easy to confuse the two.
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Frequently asked questions
Do I qualify for CHC funding?
It depends on whether your needs are primarily health needs, judged on nature, intensity, complexity and unpredictability. No diagnosis qualifies automatically, including dementia, and no level of savings disqualifies you.
Is it means-tested?
No. Savings, income and property are irrelevant, and there is no family contribution if it is awarded.
Can it be provided at home?
Yes. Continuing Healthcare can be delivered at home, in a care home or elsewhere, and the setting is part of what the assessment considers.
How do I start the process?
Ask a GP, hospital team or your Integrated Care Board for a Continuing Healthcare Checklist. Use that word, because asking generally about NHS funding tends to go nowhere.
Is an award permanent?
No. Eligibility is reviewed, usually after three months and then annually, and it can be withdrawn if needs change so that the primary health need threshold is no longer met.
Can we claim back what we have already paid?
Retrospective claims are possible in some circumstances, and they are complicated and time-limited. Take free advice from Age UK before paying anyone a percentage to pursue one.
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About Visiting Angels Cheshire East
Visiting Angels Cheshire East provides care at home across Macclesfield, Wilmslow, Knutsford, Congleton, Alsager and the villages of East Cheshire, along with Buxton, Whaley Bridge and the Staffordshire Moorlands towns.
- You choose your caregiver. You meet them before care starts, and if it is not right you say so and we send someone else.
- No visit is ever shorter than an hour. There is no such thing as a fifteen minute call here.
- You see the same faces. Our carer turnover is 12 per cent, against a sector figure of 23.7 per cent (Skills for Care, 2025).
- Carers trained in dementia, Parkinson’s, stroke recovery and complex care, with training designed and overseen by clinicians.
- Live-in care available, up to full time.
Alan’s wife is supported at home, and this is what he wrote:
“Excellent in every respect. Staff are caring, friendly and helpful. [Our carers] do everything they can to make my wife’s life easier. Management and staff are flexible in their approach and do the unpleasant jobs with a smile and willingness which is commendable. They are always willing to ‘go the extra mile.'”
Alan Hallett, Google review
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Not sure what you need yet? Start with a free assessment
Our free home care assessment is a visit at a time that suits you, with no obligation afterwards. In it we will:
- Work out what is actually difficult, and which times of day, which is usually what a visit should be built around.
- Talk through a realistic package, and what it would cost.
- Look at the money with you, and point you towards the funding, benefits and grants you may be entitled to, including the ones most families are never told about.
- Tell you honestly if you do not need us yet, or if someone else is a better fit.
If needs are complex and you are trying to work out which system you are dealing with, call us on 01625 720157. You can also send an enquiry, and you can read more about how we work.
Authored by Dr Niall Jawad, Director, Visiting Angels Cheshire East.
Published 6 September 2026. Last updated 6 September 2026.
This article is general information about NHS funding, not medical, legal or financial advice, and it is no substitute for advice about an individual’s circumstances. The author is a director of the company and is not acting in a clinical capacity, and Visiting Angels Cheshire East provides personal care at home rather than medical or nursing care. Eligibility decisions rest with your Integrated Care Board and the national framework changes over time; the position here was correct at the date of publication. Free independent advice is available from Age UK and Citizens Advice. To the fullest extent permitted by law, GB Care at Home Ltd accepts no liability for any loss arising from reliance on this article.
