If you or your loved one have a disability or long-term complex care needs, you may qualify for free NHS continuing healthcare (CHC). Many people are unaware of NHS continuing healthcare, so it’s important to check if you’re eligible and arrange an assessment. NHS continuing healthcare can be provided in a variety of settings – including in your own home.

What is NHS continuing healthcare?

In England, Wales and Northern Ireland, NHS continuing healthcare funding is available for people whose primary need is related to their health. The NHS is responsible for fully funding long-term care needs in any setting, including your own home, hospices and care homes. In England, you have the choice of receiving continuing healthcare funding as a direct payment (known as a personal health budget), or having the NHS arrange care for you.

Continuing care funding eligibility

To find out whether you’re eligible for NHS continuing healthcare funding, you will need to be assessed by a team of healthcare professionals who will consider your needs in relation to:

  • The kind of help you need
  • How complex your needs are
  • Any risks that might arise if you do not receive the right care at the right time

It’s important to note that the criteria for continuing healthcare funding is not dependent on a particular condition, but on your assessed needs. This means that if your needs change over time, your funding may change over time, too.

NHS continuing care assessments

The first stage of determining whether you’re eligibile for NHS continuing healthcare funding is an initial assessment carried out by a healthcare professional either at hospital or in your own home. Following this initial assessment you will be told whether you meet the criteria for continuing healthcare funding, and if you are going to be referred for a full assessment of eligibility.

Full continuing care assessments should be carried out by a mutlidisciplinary team made up of a minimum of two healthcare professionals from different care professions. This team will then assess your needs against the following areas:

  • Mobility
  • Breathing
  • Continence
  • Communication
  • Nutrition (food and drink)
  • Skin (including ulcers and wounds)
  • Psychological and emotional needs
  • Levels of consciousness
  • Medication
  • Cognition (understanding)

Once this assessment has taken place, your needs will be marked as priority, severe, high, moderate, low or no needs. You should expect to be eligible for NHS continuing healthcare funding if:

  • You have at least one priority need or severe needs in at least two areas
  • You have a severe need in one area plus a number of other needs
  • If you have a number of high or moderate needs (depending on their nature, intensity, complexity or undpredictability)

You should be fully involved in the process of completing your continuing care assessment, including being kept informed and having your views taken into account. Typically, you should receive a decision about your eligibiltiy for a full assessment within 28 days of your initial assessment or request for a full assessment.

What happens if you’re refused continuing healthcare funding?

If you are not eligible for NHS continuing healthcare funding, you may still be entitled to other NHS services. These include:

  • Palliative care
  • Respite heatlh care
  • Rehabilitation and recovery
  • Community health services specialist suport for healthcare needs
  • NHS-funded nursing care

Alternatively, there may be local authority funding to meet some of your care needs.

If I’m eligible for NHS continuing healthcare funding, what are the next steps?

If you fit the criteria for continuing healthcare funding, the next step is to arrange care that meets your assessed needs. Depending on your situation, different options may be available, including receiving support in your own home from a private live in carer.

If you’re considering care options and would prefer to remain living in the comfort of your own home, your live-in carer can provide matched, professional help and support on a long-term basis. Our live-in care matching service is an affordable alternative to residential settings, and is also available on a short term respite basis.

To find out more on the benefits of live-in care, or to talk through any questions, contact our team of friendly experts today.