The Complete Guide to NHS Continuing Healthcare (CHC)
Most people assume that social care in the UK is means-tested—meaning if you have savings, you pay for it yourself. While this is generally true, there is a major exception: NHS Continuing Healthcare (CHC).
CHC is a package of ongoing care that is arranged and funded solely by the NHS. It is free at the point of delivery, and crucially, it is not means-tested. However, qualifying for it is difficult and the assessment process can be complex. This guide explains how it works.
The Golden Rule:
CHC is based on your assessed health needs, not your diagnosis or your financial situation. A millionaire with a ‘Primary Health Need’ is just as eligible as someone with no savings.
If you are eligible, the NHS pays for 100% of your care costs.
- If you are in a care home: The NHS pays your care home fees (care + accommodation).
- If you are in your own home: The NHS pays for the healthcare and personal care support you need (e.g., paying for a home care agency like Cardea Healthcare).
Do I Qualify? The “Primary Health Need” Test
To qualify, you must have a ‘Primary Health Need’. This means your main need for care relates to your health, rather than just social care needs (like needing help washing, dressing, or cooking).
The 4 Key Indicators:
- Nature: How does your condition affect you? Is it particular or distinct?
- Intensity: How severe are the needs? Do they require continuous care?
- Complexity: Do symptoms interact? Is it hard to manage the condition?
- Unpredictability: Is the condition unstable? Can it change rapidly and dangerously?
The Assessment Process: How to Apply
Step 1: The Checklist Assessment: Usually done by a nurse or social worker. It’s a screening tool. If you pass this, you move to the full assessment.
Step 2: The Decision Support Tool (DST): A “Multidisciplinary Team” (MDT) will meet to assess your needs across 12 “domains” (e.g., breathing, mobility, skin integrity, behaviour).
Step 3: The Recommendation: The MDT makes a recommendation to the Integrated Care Board (ICB), who makes the final decision.
Fast Track: For those with a “rapidly deteriorating condition” who may be entering the end of life, there is a Fast Track pathway that bypasses the standard assessment for immediate funding.
What is NHS Funded Nursing Care (FNC)?
If you are assessed for CHC and found not eligible, but you live in a nursing home, you may still be entitled to NHS Funded Nursing Care (FNC). This is a weekly contribution paid by the NHS directly to the nursing home to cover the cost of registered nursing care. For 2024/25, the standard rate is £235.88 per week. It is tax-free and non-means-tested, but unlike CHC, it does not cover the full cost of the placement.
Expert Care for Complex Needs in Northamptonshire
Whether your care is funded by the NHS (CHC), Direct Payments, or privately, you need a provider capable of handling complex health needs. At Cardea Healthcare Northamptonshire, our team is experienced in delivering high-level clinical and personal care at home, often supporting clients with CHC funding.
Summary
CHC is free and not means-tested.
- CHC is free and not means-tested.
- It is for people with a Primary Health Need.
- The assessment involves a Checklist followed by a DST.
- If you don’t qualify, ask about FNC (Funded Nursing Care) for people with a Primary Health Need.