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NHS Continuing Healthcare (CHC) Funding: How to Qualify & Prepare for the Assessment

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NHS Continuing Healthcare (CHC) Funding: How to Qualify & Prepare for the Assessment

CHC is non‑means‑tested NHS funding for adults whose care needs are primarily health‑related.

Eligibility depends on the nature, intensity, complexity, and unpredictability of needs—not diagnosis.


1. What CHC Funding Provides

  • Fully funded care from the NHS covering all assessed health and social care needs
  • Available in any setting: your home, residential care home, or nursing home
  • Includes support with personal care, nursing care, equipment, and therapies
  • Not affected by savings, income, or property ownership (unlike local authority funding)
  • May include a personal health budget to tailor care to individual needs

2. Who Qualifies for CHC

  • Individuals with a primary health need requiring ongoing, intensive support
  • Needs assessed across 12 domains such as behaviour, cognition, mobility, and medication
  • Eligibility often met through one Priority level need or two Severe needs
  • Consideration of how needs interact: complexity, intensity, and unpredictability
  • Diagnosis alone does not determine eligibility—needs must be significant and health‑driven

3. Understanding the CHC Assessment Process

  • Checklist Assessment: Initial screening to determine if a full assessment is required
  • Full Assessment (DST): Multidisciplinary team evaluates needs across all domains
  • MDT Recommendation: Team proposes eligibility based on evidence and scoring
  • ICB Decision: Integrated Care Board reviews MDT recommendation and issues outcome
  • Fast‑Track Option: Immediate funding for rapidly deteriorating or end‑of‑life conditions

4. How to Prepare for the CHC Assessment

  • Collect evidence: care notes, hospital discharge summaries, GP letters, risk assessments
  • Keep a daily log of needs, incidents, and fluctuations to demonstrate unpredictability
  • Ensure professionals involved in care provide updated reports and assessments
  • Attend the MDT meeting to clarify needs and challenge understatements
  • Present needs as they appear on the worst days, not occasional good days

5. What to Do If CHC Funding Is Refused

  • Request a local resolution meeting to challenge the decision with additional evidence
  • Ask for a detailed breakdown of domain scores to identify areas for dispute
  • Escalate to an Independent Review Panel if the local review is unsatisfactory
  • Consider NHS‑Funded Nursing Care (FNC) if CHC is not granted but nursing needs exist
  • Reapply if needs change—eligibility can shift as conditions progress

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