CHC funding: who qualifies and how to get it in England
CHC funding (NHS Continuing Healthcare) is care that the NHS arranges and pays for in full when an adult's main need is a health need. It isn't means tested. In England, a short Checklist comes first, then a full assessment using the Decision Support Tool, and the integrated care board decides.
What is CHC funding?
CHC funding is the NHS paying for the whole of a person's care because their needs are mainly health needs. CHC stands for NHS Continuing Healthcare. You'll also see it called continuing healthcare funding, NHS continuing care funding or just continuing care, which all mean the same thing. In England, one rulebook covers them all: the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. The Department of Health and Social Care publishes it.
The Framework's glossary defines CHC as "a complete package of ongoing care arranged and funded solely by the NHS, for adults with the highest levels of complex, intense or unpredictable needs, who have been assessed as having a 'primary health need'" (page 167). In everyday terms, that means:
- In a care home, the NHS pays the full fees, including the room, meals and care (page 22).
- At home, the NHS pays for all the care and support the person is assessed as needing. Rent, food and normal household bills still come from the person's own income and benefits (page 95).
- It can be provided in any setting, including a hospice (page 24).
CHC funding isn't means tested, so savings, income and the family home play no part (page 24). That's the biggest difference from council-funded care. Our guide to what NHS Continuing Healthcare is covers the basics. This page explains how to get it.
Who qualifies for CHC funding?
A person qualifies when an assessment finds they have a "primary health need". So what qualifies you for CHC funding in practice? The Framework says it's about "the level and type of their overall actual day-to-day care needs taken in their totality". It isn't based on the reason someone needs care or on their diagnosis (National Framework, page 22). Put simply, the question is whether most of the care a person needs is there to manage or prevent health problems.
To answer that question, the assessment looks at four characteristics of the person's needs. The Framework says each one, "alone or in combination", can show a primary health need (page 24).
| Characteristic | What the Framework means | Questions to ask about your relative |
|---|---|---|
| Nature | The type of needs, physical or mental, and the kind of care it takes to manage them | What kind of help do they need, and how skilled does it have to be? |
| Intensity | How much care is needed, how severe the needs are, and how continuous the support has to be | How often does someone step in, by day and by night? |
| Complexity | How the needs show themselves and interact, and the skill needed to monitor and manage them | Does one condition make another harder to treat or care for? |
| Unpredictability | How much the needs change, and the risk to health if care isn't given in time | What happens when care is late, and how often do things change without warning? |
These things don't decide eligibility:
- The diagnosis. The Framework says a diagnosis "is not in itself a determinant of eligibility" (page 24).
- Where the care happens, whether that's a care home, a hospice or the person's own home (page 24).
- Who gives the care, so needs met by family or by care workers still count (page 24).
One more rule catches many families out. The Framework says "well-managed needs are still needs" (page 51). If carers keep someone's skin healthy or their behaviour settled, the need for that skilled care still counts. Our guide to the criteria for CHC funding works through each test in more detail.
What conditions qualify for continuing healthcare?
No condition qualifies for continuing healthcare on its own, because the National Framework looks at needs instead of diagnoses. Two people with the same illness can get different decisions, since their day-to-day care can look very different.
Dementia, stroke, Parkinson's, motor neurone disease and end of life care often bring the needs the assessment looks for, such as:
- behaviour that puts the person or others at risk, or that needs skilled handling
- difficulty swallowing, or a feeding tube that needs skilled care
- breathing problems that need regular treatment or oxygen
- pressure sores or fragile skin that need treatment several times a day
- medicines that a nurse has to give or watch closely, including pain relief
- seizures, blackouts or other changes in consciousness
- falls, or being unable to bear weight or help with moving
- confusion and memory loss that put the person at risk of harm
The full assessment covers 12 areas of need, from breathing and nutrition to cognition, behaviour and medication (Decision Support Tool guidance, updated 22 October 2026). Notes on what care is given, how often and by whom are usually more useful than a folder of diagnosis letters.
How does the CHC funding process work?
In England, the process for continuing healthcare funding follows a set order. A short screening Checklist comes first. If it's positive, a team carries out a full assessment using the Decision Support Tool. Then the integrated care board (ICB), the NHS body that runs CHC funding for your area, makes the decision. England has had 36 ICBs since 1 April 2026 (NHS England data, November 2026).
The steps at a glance
Screening Checklist
A trained nurse, doctor, social worker or other practitioner scores 11 areas of need as A, B or C. The scores show whether a full assessment is needed.
Full assessment with the DST
A team of at least two professionals completes the Decision Support Tool across 12 areas of need and recommends a decision. Your relative, and you as their representative, can take part.
Decision by the ICB
The integrated care board decides and writes to you with its reasons and how to ask for a review.
Funding and reviews
The NHS funds the care. The ICB reviews it within three months, then at least once a year.
Challenging a refusal
First you ask the ICB to look again, which is called local resolution. Then you can ask NHS England for an Independent Review Panel, and after that go to the Ombudsman.
The Checklist
The NHS Continuing Healthcare Checklist is a short screening tool. A trained practitioner, such as a nurse, a GP or a social worker, scores 11 areas of need as A, B or C (National Framework, page 42). You can ask the ICB for one. You should normally have the chance to be there when it's completed (page 42). A full assessment is needed when the Checklist shows any of these (NHS Continuing Healthcare Checklist, October 2026):
- two or more A scores
- five or more B scores, or one A and four B scores
- an A in one of the four priority areas: breathing, behaviour, drug therapies and medication, or altered states of consciousness
The Framework says the threshold "has intentionally been set low" (page 40). A positive Checklist only means the person is entitled to a full assessment (page 42). Our CHC Checklist guide explains every area and score. If you already have a completed Checklist, the free Checklist score checker shows whether the scores meet the threshold.
The full assessment and the Decision Support Tool
A multidisciplinary team (MDT) carries out the full assessment. The Framework defines this as "a team of at least two professionals, usually from both the health and the social care disciplines" (glossary, page 167). The team uses the Decision Support Tool (DST), the form that records needs in 12 areas. Each area gets a level from no needs up to high, severe or priority, depending on the area. Four areas can reach priority. The guidance expects a clear recommendation of eligibility if there's one priority level, or severe needs in two or more areas. Other mixes of high and moderate needs may also show a primary health need (Decision Support Tool guidance, updated 22 October 2026).
Your relative should be fully informed and able to take part. They can have a representative, such as a family member, if they wish (pages 28 and 118). The DST has a section for your views on the level chosen in each area. Any disagreement should be recorded with reasons (Practice Guidance 24.2, page 137). If you disagree with a level, say so at the meeting.
The decision and the 28 days
The team sends its recommendation to the ICB, which should normally respond within 48 hours (two working days). The time from the ICB receiving a positive Checklist to the decision should usually be no more than 28 calendar days (National Framework, page 55). The Framework says the team's recommendation should be set aside "only in exceptional circumstances, and for clearly articulated reasons" (page 54). The decision letter should give the reasons and include a copy of the completed DST. It should also explain how to ask for a review (page 55).
The Fast Track
The Fast Track is for someone whose condition is getting worse quickly and who may be entering a terminal phase. A doctor or registered nurse involved in their care can complete the Fast Track Pathway Tool. It replaces the Checklist and the DST (page 77). The ICB must accept a properly completed tool and act on it straight away. The care package should not usually take more than 48 hours to put in place (page 79).
Reviews after funding starts
Once CHC funding starts, the ICB reviews it within three months of the decision and then at least once a year (page 61).
Not sure which stage you're at?
The free CHC funding check asks 18 short questions about the care your relative needs. It shows whether a full assessment looks worth asking for. If you'd rather talk it through, ask us to call you back.
How do you apply for CHC funding?
For care someone needs now, you apply by asking for a Checklist. You can ask the ICB directly. Or you can ask a professional who's already involved, such as the GP, a social worker, the hospital discharge team or the care home nurse. A person can't refer themselves by filling in a Checklist, but they or their family can ask the ICB for one (National Framework, page 42).
People often look for a CHC funding application form. For care needed now, the Checklist is the first form, and a trained professional fills it in with you. Care that's already been paid for has its own application, which we cover further down.
- Ask in writing. A short email or letter is enough. Give your relative's name and date of birth, and say you're asking for an NHS Continuing Healthcare Checklist. Then describe their care needs in a few plain sentences.
- Gather what shows the care. Care plans, care home daily notes, a list of medicines, hospital letters and your own notes on the help given each day and night.
- Keep a record. Note who you asked and when. The completed Checklist should go to the ICB "without delay" (Checklist, October 2026). You should normally be given a copy (National Framework, page 183).
- Ask for the outcome in writing. If the Checklist is negative, you can ask the ICB to reconsider. It should give the request due consideration, although it doesn't have to carry out another Checklist (page 43).
How long does it take to get CHC funding?
The Framework expects a decision within 28 calendar days of the ICB receiving a positive Checklist. In hospital, when the person is otherwise ready to leave, it expects "far fewer than 28 calendar days" (pages 55 to 56). In practice, 67.5% of standard referrals in England were completed within 28 days between July and September 2026. On 30 September 2026, 2,322 referrals had been waiting longer than 28 days (NHS England CHC and FNC data, Q2 2026/27, published 12 November 2026, our sums).
Sometimes the ICB takes longer than 28 days without good reason, and the person is then found eligible. If the person or the council paid for care in the meantime, the ICB should refund the cost from day 29 to the decision date (National Framework, Annex E, pages 178 to 179). The ICB can refuse if it shows the delay was outside its control, such as waiting for records from another organisation or the family.
| Stage | Timescale | Source |
|---|---|---|
| Completed Checklist sent to the ICB | Without delay, with no set number of days | NHS Continuing Healthcare Checklist, October 2026 |
| ICB responds to the team's recommendation | Normally within 48 hours (two working days) | National Framework, page 55 |
| Positive Checklist to the decision | Usually no more than 28 calendar days | National Framework, page 55 |
| Refund when the ICB is late without good reason | Care costs from day 29 to the decision, if the person is found eligible | National Framework, Annex E, pages 178 to 179 |
| Fast Track care package in place | Should not usually take more than 48 hours | National Framework, page 79 |
| First review once funding starts | Within three months, then at least once a year | National Framework, page 61 |
| Asking for local resolution | Set by each ICB, with no national time limit | National Framework, page 67 |
| Independent Review Panel | Typically three to six months | NHS England independent review guide, July 2023, page 5 |
How difficult is it to get CHC funding?
In the 12 months to September 2026, 17.4% of standard CHC assessments in England found the person eligible. That's 8,950 out of 51,327 (NHS England CHC and FNC data, Q2 2026/27, published 12 November 2026, our sums). Over the same 12 months, the rate varied from 5.0% in one ICB to 41.4% in another.
NHS England says differences between areas have many causes, including the age and health needs of local people and the other services available locally. A low rate in one area doesn't on its own show that anything has gone wrong.
Decisions can also change on review. Over the same 12 months, 2,786 local resolution reviews were completed in England. In 406 of them, or 14.6%, the person was found eligible (same source, our sums).
You can't change the national rate, but you can make sure the assessment sees the full picture. That means care records that show the real level of need and a diary of the hardest days and nights. A clear account from the people who give the care helps too. Our CHC assessment support service prepares that evidence with you before the meeting.
How much is CHC funding per week?
There's no fixed weekly amount of CHC funding. The NHS pays the full cost of the care package it agrees. So the amount depends on the person's needs and where the care happens.
NHS-funded Nursing Care (FNC), a smaller NHS payment towards nursing in a care home, does have a set rate. From 1 April 2026 the standard rate is £267.68 a week, paid to the care home with nursing (Department of Health and Social Care, 9 March 2026).
What happens if the answer is no?
A refusal of CHC funding doesn't always mean the NHS pays nothing. Someone in a care home with nursing who needs care from a registered nurse can get FNC, a set weekly amount towards that nursing. The Framework says CHC should always be considered first (page 9). The NHS may also share the cost with the council in a joint package of care. This happens where specific health needs go beyond what the council can meet (page 88). Otherwise the council assesses the person's care needs and then their money.
| Question | NHS Continuing Healthcare | NHS-funded Nursing Care | Council funding |
|---|---|---|---|
| Who pays | The NHS pays for all the assessed care | The NHS pays a set weekly amount towards nursing | The council pays some or all of the cost |
| Means tested | No | No | Yes |
| Where it applies | Any setting, including the person's own home | Care homes with nursing only | At home or in a care home |
| The test | A primary health need | A need for care from a registered nurse, best met in a care home with nursing | Care needs under the Care Act 2014, then a financial assessment |
| How much | The full cost of the agreed package | £267.68 a week at the standard rate from 1 April 2026 | Depends on the means test |
For the full picture of how care is paid for, see our guide to who pays for care home fees.
You can also challenge the decision. The first step is local resolution, where the ICB looks again using its own published process. If that doesn't settle it, you can ask NHS England for an Independent Review Panel (page 68). After that, you can complain to the Parliamentary and Health Service Ombudsman (page 70). Our CHC appeals service takes you through local resolution and the Independent Review Panel. If you'd like our view before you decide, a CHC case review tells you in writing whether a challenge looks worth making.
Check your ICB's time limit
The Framework sets no national time limit for asking for local resolution (page 67), so each ICB sets its own. One ICB we checked, Gloucestershire, gives six months from the date of the decision letter. Read your letter and your ICB's policy as soon as the decision arrives.
Can you claim back care fees you've already paid?
Sometimes. If your relative paid for care when they should have been considered for CHC funding, you can ask the ICB to assess that past period. The official name is a previously unassessed period of care. ICBs should generally only look at care from 1 April 2012 onwards. They should look at earlier periods only in rare, exceptional circumstances (Department of Health and Social Care guidance, updated 19 March 2025). You can still ask after a death, as the executor or administrator of the estate.
The process has its own time limits once you start, such as 28 days to return the application and consent forms (same guidance). Our guide to retrospective CHC claims explains the evidence and each step. Our service to claim back care fees can make the claim for you.
Does CHC funding apply in Scotland and Wales?
This guide covers England only, because the National Framework applies only in England. Scotland replaced NHS Continuing Healthcare on 1 June 2015 with Hospital Based Complex Clinical Care, which is for care in hospital only (Scottish Government, DL (2015) 11). Wales has its own Continuing NHS Healthcare framework, in use since 1 April 2022 (Welsh Government). The English Framework doesn't cover Northern Ireland either. If your relative lives outside England, check the rules for that nation.
Where can you get help with CHC funding?
You don't have to pay anyone to apply for NHS Continuing Healthcare funding. The Checklist and the full assessment cost nothing, and you can ask for them yourself. Charities such as Age UK also publish free information.
If you'd like someone to run the case with you, that's what we do. CHC Funding Support helps families in England at every stage, from the first Checklist to an appeal or a claim for past fees. You'll find what each service includes, and every price, on our prices page. Before any work starts, you'll get a written quote.
Questions families ask
What are the 4 criteria for CHC funding?
People often call them the four criteria, and the National Framework calls them the four characteristics of need: nature, intensity, complexity and unpredictability. The assessment uses them to decide whether the person has a primary health need. Each one, alone or with the others, can show that the main part of the care is health care (National Framework, pages 23 to 24).
Is CHC funding means tested?
No. The National Framework says financial issues should not be considered as part of the decision (page 24). Savings, income, pensions and the family home make no difference to whether someone qualifies for CHC funding. Money only matters if the person isn't eligible and the council helps with the cost instead. Council funding is means tested.
Is CHC funding backdated?
It can reach back in two ways. If the ICB takes more than 28 days to decide without good reason, it should refund care costs from day 29 to the decision date. This applies when the person is then found eligible (National Framework, Annex E). And if someone paid for care that should have been considered for CHC, you can ask the ICB to assess that past period. This normally covers care from 1 April 2012 onwards.
Do you lose Attendance Allowance if you get CHC funding?
If CHC funding pays for a care home place, gov.uk says most benefits usually stop within 28 days. It lists Attendance Allowance among the benefits you may keep only when you pay the care home fees yourself. Tell the office that pays the benefit when CHC funding starts. If the care is at home, ask the Attendance Allowance helpline how the funding affects the claim.
Can CHC funding be stopped?
Yes, if a review finds that the person no longer has a primary health need. The Framework says care must be taken not to mistake well-managed needs for needs that have gone. Funding should not be withdrawn without a joint reassessment, and other funding should be agreed and in place first (pages 61 to 62).
Who decides CHC funding?
The integrated care board (ICB), the NHS body that runs CHC for your area, makes the decision (National Framework, page 24). A team of at least two professionals completes the Decision Support Tool and recommends a decision. The ICB should follow that recommendation except in exceptional circumstances, for clearly stated reasons (page 54). In a Fast Track, the doctor or nurse who completes the tool decides that the person has a primary health need.
This is information, not legal advice. It explains the rules for England, which are set out in the National Framework for NHS Continuing Healthcare.
Sources
- National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, Department of Health and Social Care, July 2022 revision, corrected July 2023.
- NHS continuing healthcare checklist and guidance, Department of Health and Social Care, updated 20 October 2026.
- NHS continuing healthcare decision support tool and guidance, Department of Health and Social Care, updated 22 October 2026.
- NHS continuing healthcare fast track pathway tool and guidance, Department of Health and Social Care, updated 20 October 2026.
- Dealing with requests for assessments of previously unassessed periods of care from 1 April 2012, Department of Health and Social Care, updated 19 March 2025.
- NHS Continuing Healthcare: independent review process, public information guide, NHS England, version 3, 3 July 2023.
- NHS Continuing Healthcare and NHS-funded Nursing Care quarterly data, Q2 2026/27, NHS England, published 12 November 2026.
- Better community care thanks to nursing funding boost, Department of Health and Social Care, 9 March 2026.
- Report a care home stay if you claim benefits, GOV.UK, read 13 November 2026.
- Continuing NHS Healthcare: the national framework for implementation in Wales, Welsh Government, in use from 1 April 2022.
- DL (2015) 11, Hospital Based Complex Clinical Care, Scottish Government, 2015.