Continuing Healthcare FAQs
What is NHS Continuing Healthcare?
NHS continuing healthcare is the name given to a package of care that is arranged and funded solely by the NHS for individuals who are not in hospital who have complex ongoing healthcare needs.
Where is NHS Continuing Healthcare provided?
If you are eligible, you can receive NHS continuing healthcare:
- In your own home:
The NHS will pay for healthcare, such as services from a community nurse or specialist therapist, and personal care, such as help with bathing, dressing and laundry
- In a care home:
As well as healthcare and personal care, the NHS will pay for your care home fees, including board and accommodation
NHS continuing healthcare is free, unlike social and community care services provided by local authorities for which a charge may be made, depending on your income and savings.
Who may eligible for NHS continuing healthcare?
To be eligible for NHS continuing healthcare you must:
- Be over 18 and
- Have a complex medical condition and substantial and ongoing care needs and
- You must have a ‘primary health need’, which means that your main or primary need for care must relate to your health.
Eligibility for NHS continuing healthcare does not depend on:
- A specific health condition, illness or diagnosis
- Who provides your care
- Where your care and support is provided
How do I find out if I am eligible for NHS Continuing Healthcare?
To find out whether you are entitled to have your long-term care provided by the NHS you can have an assessment of your needs. Health or social care professionals should seek your consent (or consent from your representative) before they complete any assessments with you to ensure that you can make an informed decision about the process.
Step One – Continuing Healthcare Checklist Tool
The first step for most people is to have an initial assessment with a health or social care professional, (who ideally knows you and your needs well) using a screening tool called the Checklist Tool.
The Checklist Tool will indicate whether or not you should be referred for a more in-depth assessment of your needs. The Checklist Tool helps health and social care professionals to identify if your care needs may be of a level or type that could entitle you to NHS continuing healthcare.
The Checklist Tool is usually completed when a health or social care professional, meets with you to assess or review your health or social care needs.
For example: A Nurse or Doctor could complete the Checklist Tool with you before you leave hospital or a Social Worker could complete the screening with you when carrying out a community care assessment, usually when you are at home.
Your local Clinical Commissioning Group will confirm with you in writing whether or not you will be referred for a full assessment for NHS continuing healthcare.
You should be fully involved in the assessment and decision-making process. Your views about your care and support needs for will be taken into account. If you feel that you need help to explain your views, you may want to ask a friend or relative for support. You can also access support from a specialist Continuing Healthcare Advocate to assist you through the process. Click here for more information
Step Two- Decision Support Tool
If the Checklist Tool indicates that you may be eligible for NHS continuing healthcare, the person who completed it with you will contact your local Clinical Commissioning Group to arrange a full assessment of all your care needs.
Your assessment should be carried out by a multidisciplinary team and your needs will usually be recorded in a document called the Decision Support Tool.
With your permission, the assessment will include contributions from all the health and social care professionals involved in your care, to give an overall picture of your needs. This could include professionals such as a Social Worker, District Nurse or Carers. In some cases, more detailed specialist assessments may be required from these professionals.
Your views and those of any family or friends that support you should also be taken into consideration.
The Decision Support Tool is used to decide whether your main or primary care needs relate to your health, by looking at different areas of your care needs including:
- Psychological and emotional needs
- Drug therapies and medication
- Altered states of consciousness
For individuals who need an urgent package of care because their condition is deteriorating rapidly, the Fast Track Tool may be used instead. This enables the Clinical Commissioning Group to arrange for care to be provided as quickly as possible.
Step Three- Following the Assessment
The multidisciplinary team will make a recommendation to the Clinical Commissioning Group about your eligibility for NHS continuing healthcare based on the evidence and information collected about your needs.
If you qualify for NHS continuing healthcare and you wish to continue living at home or with a relative you can choose to receive your care and support through a personal health budget, which offers you greater choice and control over the care that you need.
For more information about personal health budgets click here
What if my care needs change?
Your care needs will be reviewed regularly to ensure that you are receiving the appropriate level of care and that you continue to meet the eligibility criteria for NHS continuing healthcare.
If I receive continuing healthcare funding, will it affect my benefits?
If you are receiving continuing healthcare funding and you are living at home, with a friend or relative then your benefits will not be affected.
If you receive continuing healthcare funding and you are living in a care home then your Attendance Allowance or Disability Living Allowance is likely to be affected. In addition, if you receive other means-tested benefits such as Income Support or Pension Credit, if you receive a disability premium as part of your benefits, this may also be affected.
If your care needs change, there is a range of ways that your care needs may be met and / or funded either by the NHS or your Local Authority. For more information please visit our Funding information page.