{"id":7593,"date":"2026-09-21T16:55:48","date_gmt":"2026-09-21T16:55:48","guid":{"rendered":"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/?p=7593"},"modified":"2026-09-21T17:36:47","modified_gmt":"2026-09-21T17:36:47","slug":"nhs-continuing-healthcare","status":"publish","type":"post","link":"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/nhs-continuing-healthcare\/","title":{"rendered":"NHS Continuing Healthcare: free care at home explained"},"content":{"rendered":"\t\t
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Quick summary<\/b><\/h3>

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.<\/span><\/p>

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What is NHS Continuing Healthcare?<\/b><\/h3>

A package of care arranged and funded entirely by the NHS for adults assessed as having a primary health need.<\/span><\/p>

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 (<\/span>Age UK<\/span><\/a>).<\/span><\/p>

The word that decides everything is “primary”.<\/b> 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.<\/span><\/p>

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Why does nobody mention it?<\/b><\/h3>

Because the people families talk to most are usually not the people who hold it.<\/span><\/p>

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.<\/span><\/p>

The practical consequence: families with savings above \u00a323,250 are told they will pay for everything, which is true for social care and may not be true here.<\/span><\/p>

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How does the assessment work?<\/b><\/h3>

Two stages:<\/span><\/p>

Stage one is the Checklist.<\/b> 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.<\/span><\/p>

Stage two is the full assessment<\/b>, carried out by a multidisciplinary team using the Decision Support Tool. It scores needs across twelve care domains, from no needs up to priority.<\/span><\/p>

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 (<\/span>NHS<\/span><\/a>).<\/span><\/p>

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What counts as a primary health need?<\/b><\/h3>

It is assessed against four characteristics of the needs, rather than against a diagnosis.<\/span><\/p>

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Characteristic<\/b><\/p><\/th>

The question behind it<\/b><\/p><\/th><\/tr><\/thead>

Nature<\/b><\/p><\/td>

What kind of needs are these, and what kind of help do they require<\/span><\/p><\/td><\/tr>

Intensity<\/b><\/p><\/td>

How severe are they, and how much support do they need, including continuity<\/span><\/p><\/td><\/tr>

Complexity<\/b><\/p><\/td>

How do the needs interact, and does managing them require skilled judgement<\/span><\/p><\/td><\/tr>

Unpredictability<\/b><\/p><\/td>

How much do they fluctuate, and what happens if care is not delivered promptly<\/span><\/p><\/td><\/tr><\/tbody><\/table>

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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.<\/span><\/p>

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.<\/span><\/p>

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The challenge<\/b><\/h3>

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.<\/span><\/p>

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.<\/span><\/p>

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.<\/span><\/p>

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Fast track<\/b><\/h3>

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.<\/span><\/p>

If a clinician has raised end of life care, ask specifically whether a fast track application is appropriate.<\/span><\/p>

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What if we are turned down?<\/b><\/h3>