Continuing Healthcare

Eligibility for NHS continuing healthcare funding is determined by a detailed assessment, which looks at all aspects of a person’s health and social care needs.  As part of this, four key areas are considered:

• The type of condition or treatment required
• The complexity of the condition (symptoms that interact and are therefore difficult to manage or control)
• The intensity of the condition (one or more health needs so severe they require regular care and support)
• The unpredictably of the condition (unexpected changes in condition that are difficult to manage and present a risk to the individual or to others)

Referral: I think I need an assessment

If someone needs to be assessed for NHS continuing healthcare, a referral should be made to the team. The referral form can be obtained from each Continuing Healthcare team (see the 'How To Apply' section above for details)

Checklist: Am I eligible for an assessment?

In order to identify whether an individual requires a full CHC assessment, a CHC checklist is undertaken. The checklist will be completed by a health or social care professional trained as part of their role. Trained professionals will identify which statement describes the level of need. To see the form, instructions and read more about the checklist, visit the Department of Health’s website.

CHC Assessment: The assessment

The holistic continuing healthcare assessment involves the patient, people caring for them, professionals and their family and/or representative. Friends, relatives and official advocates may also be present.  

Determination: Decision Making

Quality Assurance is undertaken by each place-based CHC Team. This is to ensure the assessment and recommended outcome are compliant with the National Framework and can therefore be ratified.

Appeal: Your right to recourse

If you are not happy with the decision or are concerned about the process followed, you have the right to appeal and request a review of the decision. 

Commissioning of Care: Planning your care

Individuals eligible for NHS funding, will be contacted by the CHC Team. We will work with you to identify the type of care that best meets your needs from organisations that are registered with the Care Quality Commission, and are able to demonstrate their ability to deliver satisfactory care standards. Your wishes and expectations of how and where the care is delivered should be documented and taken into account.