NHS Continuing Healthcare (CHC): Complete Guide for Families & Carers

Applying for NHS Continuing Healthcare (CHC) can feel like navigating a maze. Who makes the decision? What evidence really matters? And how do you present a complex medical history so it becomes a clear case for funding?

This guide explains everything step by step, from checking eligibility to appealing with practical tips, real-world examples, and expert advice. If you need personalised help, HTR Care can support you at every stage.

Who Qualifies for NHS Continuing Healthcare?

At its core, NHS Continuing Healthcare is for people whose primary need is medical rather than social.

Put simply: if a person’s health needs are so complex, intense, or unpredictable that only the NHS can safely provide and fund care, they may qualify.

Typical conditions that may qualify

• Advanced dementia with severe behavioural symptoms or repeated infections
• Complex long-term conditions needing daily clinical input
• End-of-life care requires constant symptom management
• Multiple interacting needs where different treatments and risks overlap

Does dementia count?

Yes, dementia can meet CHC criteria if it creates a primary health need, for example:

• Aggressive or unpredictable behaviour
• Frequent medical crises or infections
• Complex medication regimes requiring monitoring

For more on dementia care, see our guide: Step-by-Step Support for Dementia Patients.

The Four Key CHC Assessment Criteria

CHC assessors look at four concepts:

• Nature – What is the health need?
• Intensity – How severe is it?
• Complexity – How many needs interact and require coordination?
• Unpredictability – How often do sudden changes or risks occur?

These principles guide assessors in deciding whether someone’s care is a primary health need.

CHC vs NHS-Funded Nursing Care (FNC)

• CHC: Pays for the full cost of health-driven care, whether at home or in a care facility.
• NHS-Funded Nursing Care (FNC): Only covers the nursing element in a care home if the CHC criteria are not met.

Also Read Our Blog on: Free Home Care in the UK: Eligibility and Guide

NHS Continuing Healthcare Checklist: Evidence You’ll Need

Strong evidence makes applications more successful. You don’t need legal document, just clear, consistent records.

Documents to gather

• GP letters and hospital discharge summaries
• Medication lists and care plans
• Advance care planning notes or DNAR orders
• Consultant and specialist reports
• Nursing notes, wound-care charts, therapy records

Family and carer logs

• Notes on eating, bathing, mobility, continence, and medication
• Short, dated entries showing day-to-day needs
• Carer statements about typical days and crisis episodes

Practical tip: Keep a timeline of health events (hospital admissions, falls, infections, medication changes).

Step-by-Step: How to Apply for NHS Continuing Healthcare

Applying for NHS Continuing Healthcare (CHC) can feel overwhelming, but breaking it down into clear stages makes the process much easier to follow. Each step is designed to ensure that a person’s health needs are properly assessed and, if eligible, fully funded by the NHS. Here’s how the application process works from start to finish:

Referral

• Ask your GP, hospital team, or care home to request a CHC checklist from your local Integrated Care Board (ICB).

Initial Checklist

• A short screening tool. If it suggests a possible primary health need, you move to a full assessment.

Full Multidisciplinary Assessment (MDT)

• Conducted with the Decision Support Tool (DST)
• Covers areas such as behaviour, cognition, mobility, nutrition, and skin integrity
• Your role is to present evidence, correct inaccuracies, and highlight risks

Decision and Care Package

• If approved, the NHS will fund care from the eligibility date. Keep records of dates.

Review and Monitoring

• CHC is reviewed regularly, as needs can change.

What Happens in the CHC Full Assessment?

Think of the assessment as a structured conversation about daily life and risks.

• The DST is not a scoring system; it guides clinical judgement.
• Families can make a strong case by:
• Preparing short, specific statements for each category
• Describing unpredictability and urgent episodes
• Attending the assessment to ensure accuracy

Common pitfalls include vague evidence, missing records, or not attending the meeting.

If Your CHC Application Is Refused: Reviews and Appeals

A refusal is not the end. Here’s what to do:

Request the decision letter and assessment notes

Check why CHC was refused.

Ask for a Local Review or Reconsideration

Provide new or clearer evidence, such as updated consultant letters or detailed carer logs.

Independent Review Panel (IRP)

If the local review fails, escalate to NHS England’s IRP.

Parliamentary and Health Service Ombudsman

The final level of appeal.

Many appeals succeed because of better evidence presentation rather than new legal arguments.

How HTR Care Can Support Your CHC Application

At HTR Care, we understand how overwhelming the CHC process can be. We can help by:

• Evidence gathering: Nursing logs, handover notes, and clinical reports aligned to CHC categories
• Liaising with clinicians: Requesting up-to-date GP and hospital letters
• Care continuity: Our staffing agency ensures consistent care during assessments and reviews
• CQC-compliant training: All staff are DBS-checked and trained in medication management, safe moving, and person-centred care

If you would like personalised guidance, contact us for immediate help or book an initial guidance call.

FAQs on NHS Continuing Healthcare

1. How do I apply for NHS Continuing Healthcare?

Ask your GP, ICB, or hospital for a referral, complete the checklist, then attend the full MDT assessment with supporting evidence. HTR Care can help you in applying for NHS Continuing Healthcare

2. Can someone with dementia qualify for CHC?

Yes, if dementia leads to a primary health need such as unpredictable behaviour, frequent crises, or end-of-life care.

3. How is NHS-Funded Nursing Care different?

It pays for the nursing element only, not full health needs.

4. What scores do you need for CHC?

There is no set score. Assessors apply professional judgement based on the four key concepts.

5. What are the four CHC criteria?

Nature, Intensity, Complexity, and Unpredictability.

6. How much is NHS-Funded Nursing Care?

The NHS-funded nursing Care rates vary by area. Check with your local ICB.