NHS Continuing Healthcare: 5 Things to Know

At Liaison Care, we work daily with individuals, families, carers, and NHS organisations to navigate Continuing Healthcare (CHC) eligibility and funding.

Our experience conducting thousands of assessments has given us unique insights into this complex process. Here are five essential things to know:

1. Eligibility is about Primary Health Needs, not diagnosis

A medical diagnosis doesn’t automatically qualify or disqualify someone for CHC funding.

What matters is demonstrating that care needs are so complex, intense, or unpredictable that they constitute a ‘primary health need’ requiring NHS responsibility rather than social care.

Assessment focuses on the four key characteristics: nature, intensity, complexity, and unpredictability of care needs, across twelve care domains; breathing, nutrition, continence, skin integrity, mobility, communication, psychological and emotional needs, cognition, behaviour, drug therapies and medication, altered states of consciousness, and other significant care needs.

People do move in and out of eligibility – health needs change, and therefore so may eligibility. Regular reviews, as advised in the NHS National Framework for CHC, are carried out to ensure records always contain an accurate assessment of current needs. If an individual’s needs reduce, they may no longer be eligible for CHC funding, but equally, an increase in needs may be identified leading to an increase in care. If someone is found ineligible at any point in time, that does not mean they may not be eligible in the future if their needs change again.

2. Accurate assessments benefit everyone

CHC covers all identified care needs without personal financial contribution, including accommodation costs in a nursing or residential setting, specialist equipment, and care to meet health and social care needs. Unlike social care, an individual’s property, savings, and income aren’t assessed.

Accurate CHC application ensures resources reach those with primary health needs while often being more efficient for NHS organisations than managing inappropriate placements and subsequent appeals.

3. Structured processes protect individual rights

The CHC assessment framework provides systematic protection for individuals’ rights when properly implemented. Understanding the process empowers people to participate effectively – they can request assessment, participate fully, and receive written rationale for decisions. Run well, such assessments should be supportive, and the individual and their family should always know what is happening and why.

Consistent, well-documented processes reduce confusion, queries, appeals, and legal challenges, and improve satisfaction through use of multi-disciplinary teams, comprehensive evidence gathering, and clear decision documentation.

4. Evidence-based recommendations ensure consistency

Independent assessors like Liaison Care provide NHS organisations with robust clinical guidance for CHC funding decisions. Our assessors gather evidence from family members, social workers, care providers, and individuals themselves, ensuring recommendations fully align with the National Framework and best reflect the needs and aspirations of every individual we see.

This approach helps commissioners understand both eligibility and appropriate care packages, enabling informed decisions while managing resources effectively.

5. Professional expertise optimises outcomes

CHC assessment complexity means professional expertise benefits everyone involved.

Specialist knowledge ensures all relevant needs are properly documented and evaluated, particularly valuable for complex cases, appeals, or retrospective claims.

Our commitment

As CHC specialists, we support both individuals and NHS organisations in achieving fair, accurate, and efficient processes. When assessments are conducted correctly and compassionately with appropriate clinical expertise, the system works effectively for all.

We ensure individual voices are heard and needs are properly and independently assessed, while helping NHS organisations develop robust, consistent processes. Through professional, evidence-based approaches, we achieve outcomes that ensure individuals get the right care while ensuring appropriate NHS funding use.