NHS Continuing Healthcare at Home: Who Qualifies and How to Apply

NHS continuing healthcare (CHC) is a package of care arranged and paid for in full by the NHS for adults whose needs are mainly health needs. It is not means-tested, and it can be provided in your own home as well as in a care home. If your mum, dad or partner has complex, changing or intensive needs, they should at least be screened for it.

Local guides: London

Most families hear about CHC late. This guide explains who qualifies, how the checklist and full assessment work, how to get NHS continuing healthcare at home wherever you live in England, and how it differs from NHS-funded nursing care.

In short: ask for a CHC checklist if needs are complex or unpredictable. If the checklist is positive, a full assessment follows. If the NHS agrees there is a “primary health need”, it pays for all assessed care, at home or in a care home.

Who qualifies for NHS continuing healthcare?

Someone qualifies if they have a “primary health need”, meaning the main part of the care they need is focused on addressing or preventing health needs. It depends on the needs themselves, not on a particular diagnosis.

Assessors look at four characteristics set out in the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care:

• Nature: the type of needs (physical, mental, psychological) and the effect they have on the person.
• Intensity: how much care is needed, how severe the needs are, and how often support is required.
• Complexity: how different needs interact and how much skill is needed to manage them safely.
• Unpredictability: how hard it is to predict changes, and the risk if needs are not met promptly.

Two points families often miss. First, the Framework says eligibility decisions must not be based on diagnosis, the setting of care, or whether a care provider can cope. Second, well-managed needs are still needs: if a carer turns someone every two hours to prevent pressure sores, the need exists even though the skin is intact.

The NHS continuing healthcare checklist: who completes it and when?

The checklist is a short screening tool. It can be completed by a nurse, doctor, social worker or other health or social care practitioner who has been trained to use it. You cannot fill it in yourself, but you can ask for one and should be invited to take part.

It scores 11 areas of need as A (high), B or C (low). A full assessment should follow if the checklist shows:

• two or more domains scored A, or
• five or more scored B, or one A and four B, or
• one A in any of the domains marked with an asterisk (breathing, behaviour, drug therapies and medication, altered states of consciousness).

The threshold is deliberately low. A positive checklist does not mean someone is eligible, only that they need a full assessment. Common points at which to ask are before a hospital discharge is planned, when care needs increase sharply, when a care package is reviewed, or when someone is being considered for a nursing home.

The Framework says the full assessment should normally take place in the community, preferably at home, rather than in hospital, because a hospital stay rarely reflects someone’s longer-term needs. From a positive checklist to a decision should normally take no more than 28 days.

What happens at the full assessment?

A multidisciplinary team, usually at least two professionals from different disciplines, gathers evidence and completes the Decision Support Tool (DST). You, and anyone representing the person, should be invited. Bring your notes. Families who describe a typical week in concrete detail, including nights, usually give the team far more to work with than care records alone.

The team then makes a recommendation to the Integrated Care Board (ICB), which makes the decision. You should receive the decision and the reasons in writing.

Decision Support Tool domains and levels

The DST scores 12 care domains. Each is rated from “no needs” up to “high”, and some can reach “severe” or “priority”.

According to the DST guidance, a clear recommendation of eligibility would be expected where there is a priority need in any of the four domains that carry that level, or severe needs in two or more domains. One severe need alongside needs in other domains, or a number of high and moderate needs, may also indicate eligibility and must be considered carefully. The DST is not a points total: the team must explain how the whole picture fits the four characteristics.

How to get NHS continuing healthcare at home

If someone is found eligible, the ICB agrees a care and support plan with them and their family. At home, the NHS funds the assessed care and support, usually through a home care agency. It does not pay rent, household bills or food.

There are usually three ways the package can be run:

1. An ICB-arranged package: the NHS commissions care from an agency and manages the arrangement.
2. A personal health budget: adults eligible for CHC have a right to ask for one. It can be a notional budget held by the NHS, a budget held by a third party, or a direct payment you manage yourself, for example to employ your own carers.
3. A mix: some care commissioned by the NHS and some managed through a direct payment.

Be realistic about cost. The ICB can take value for money into account when agreeing where and how care is provided, so a home package that costs far more than a suitable alternative may be questioned. It helps to show why home is the right setting, for example the person’s wishes, their wellbeing, and the risks of a move.

Eligibility is reviewed after three months and then at least once a year. If needs improve, funding can end, so keep diaries going. For people with a rapidly deteriorating condition who may be entering a terminal phase, a clinician can use the Fast Track Pathway Tool, which skips the checklist and full assessment and should lead to care being arranged urgently. Our guide to end of life care at home explains how this usually works alongside palliative teams.

Your ICB’s continuing healthcare team: how to ask for an assessment

Wherever you live in England, CHC decisions are made by your local Integrated Care Board. Each ICB has a continuing healthcare team (sometimes called “all age continuing care”) that runs assessments and handles enquiries.

• Find your ICB: your GP surgery can tell you which one covers you, or search the NHS website by postcode.
• Contact details: look for “continuing healthcare” on your ICB’s website for a phone line and email address.
• An example: Sussex All Age Continuing Care on the NHS Surrey and Sussex ICB website

In practice, the checklist is usually started by a professional already involved: the GP, a district nurse, a hospital discharge team, or a social worker from your council’s adult social care team. Ask them directly, in writing if possible: “Please complete an NHS continuing healthcare checklist for my mother.” If they decline, ask them to record why. If someone was screened out, you can ask for a copy of the checklist.

If you disagree with a decision, you normally have six months from the decision letter to ask the ICB for a local resolution review. Our guide on how to appeal a continuing healthcare decision covers each stage.

NHS-funded nursing care vs continuing healthcare

NHS-funded nursing care (FNC) is a much smaller payment. It applies only to people living in a care home registered to provide nursing care who are not eligible for CHC but need care from a registered nurse. It is paid by the NHS directly to the home.

FNC does not help anyone receiving care at home: district nursing at home is already free on the NHS. For care at home, the choice is CHC or the usual mix of council funding and benefits such as Attendance Allowance.

If CHC is refused: what pays for care at home?

If the ICB says no, your local council may still help after a care needs assessment and financial assessment. For care at home, the value of the person’s home is ignored, and savings below £23,250 may qualify for help. Sometimes the answer is a joint package, with the NHS paying for some health-related care and the council or the person paying for the rest. Our guide to paying for home care sets out every option, and our free funding checker shows what might apply in a few minutes.

If you are arranging a package now, whether funded by the NHS or privately, the guide to choosing a home care agency covers the questions to ask.

For families in London

Most of this guide applies anywhere in England. If the person you care for lives in London, these points are specific to the capital.

What is NHS Continuing Healthcare?

NHS Continuing Healthcare is care for adults with long-term, complex health needs that is arranged and funded solely by the NHS. It can be provided anywhere, including your own home or a care home.

Where most home care is social care, which the council can charge for, CHC is healthcare, and healthcare is free at the point of use. That’s why CHC eligibility makes such a difference. As of 2026, London live-in care typically costs £1,300–£1,800 a week for one person, and much more for complex needs; if CHC applies, the NHS pays.

CHC is governed by the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (July 2022, revised, corrected July 2023).

What does CHC at home cover?

At home, CHC covers the care and support set out in your care plan, which can include personal care from carers and healthcare such as community nursing and therapy. It doesn’t usually cover everyday living costs such as rent, food and household bills.

Who runs CHC in London?

CHC is run by Integrated Care Boards (ICBs), the NHS bodies that commission local health services. London has four: West and North London (formed in April 2026 from the North West and North Central London boards), North East London, South East London and South West London. The ICB for the area where your parent’s GP is based will normally be responsible.

Tips for families in London

• Ask early. In hospital, ask the ward or discharge team whether a Checklist has been done before discharge. Under the national discharge guidance, a full CHC assessment should normally take place after discharge, in the community.
• Keep a care diary. Record falls, night-time waking, behaviour, choking, pressure sores and how long tasks take.
• Gather evidence. GP and specialist letters, district nurse notes and care agency records all help.
• Be present. Attend the assessment and check each domain score against the evidence.
• Arrange care in the meantime. Care can’t always wait for a decision. If you pay privately and are later found eligible, ask the ICB about refunds if the 28-day timescale was missed.

For the full picture of funding, see our pillar guide to paying for home care.

Frequently asked questions

Is NHS continuing healthcare means-tested?

No. If someone is eligible, the NHS pays for their assessed care in full regardless of savings, income or property. The person’s home and savings are not touched for the care the NHS funds.

Can you get NHS continuing healthcare at home?

Yes. CHC can fund care in your own home, usually through an agency or a personal health budget. The ICB will agree a care plan with you and can consider value for money when deciding how care is provided.

Does a dementia diagnosis qualify for continuing healthcare?

Not on its own. Eligibility depends on the nature, intensity, complexity and unpredictability of needs, not the diagnosis. Our guide to continuing healthcare for dementia explains which domains usually matter.

How long does a CHC assessment take?

The National Framework says the time from a positive checklist to a decision should not normally exceed 28 days. Fast Track cases should be much quicker. Delays do happen, so keep a written record of dates.

Who do I contact about CHC in my area?

The continuing healthcare team at your local Integrated Care Board. Your GP surgery can tell you which ICB covers you. The GP, district nurse or hospital discharge team can also complete a checklist.

Can CHC funding be taken away?

Yes. It is reviewed after three months and then at least annually, and ends if the person no longer has a primary health need. You can challenge that decision in the same way as a refusal.

The Care Panel is an independent publication. We are not a care provider and are not regulated by the Care Quality Commission, because we do not deliver care. Always check a provider’s own CQC registration and inspection report before you commit.

Written and fact-checked by The Care Panel. Last updated September 2026. Sources: NHS England National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (July 2022, revised); NHS Continuing Healthcare Checklist and Decision Support Tool guidance on GOV.UK; NHS Surrey and Sussex ICB; Age UK Factsheet 20; Beacon CHC. General information, not financial, legal or medical advice — figures are indicative and subject to change.

Preparing for the first step? See the CHC checklist explained: the 11 domains and how it is scored.

New guides: CHC Assessment and the Decision Support Tool Explained · Live-in Nurse at Home: What They Do and How to Check One

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See also: Discharge to assess (D2A) explained: pathways, rights and support

Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.