CHC Funding: Who Qualifies for NHS Continuing Healthcare?

NHS Continuing Health Care (CHC funding) is when a package of home care funded by the NHS, intended for people with complex care needs. CHC eligibility is assessed using several criteria, but primarily focuses on the nature of a person’s needs.
Learn more on the official NHS Continuing Healthcare guidance.

 

As part of the assessment, health care professionals will review you or your loved one’s needs across 12 areas, including:

 

  • Breathing
  • Nutrition
  • Continence
  • Mobility
  • Skin
  • Communication
  • Cognition
  • Psychological/emotional needs
  • Medications
  • Consciousness

 

Each need is scored as either No Needs, Low, Moderate, High, Severe, or Priority, based on the degree it impacts you or your loved one’s ability to live independently, thus offering a clear picture of the type of care needed. For more detail, see the Decision Support Tool used in CHC assessments.

 

CHC funding eligibility is approved if the assessment determines at least one need at the priority level, and two or more at the severe level.

 

However, it’s also possible to qualify with a range of assessment outcomes, including several high/moderate needs, or a combination of high-level needs, depending on the intensity and complexity of the needs.

 

As such, CHC eligibility is determined on an individual basis, assessing how a person’s needs interact and affect their day-to-day wellbeing and ability.

 

If you or a loved one doesn’t qualify for CHC funding, it’s possible to fund your care through the local authority or private means. You may also find support through NHS-funded nursing care if you’re in a nursing home.

 

How to Use the CHC Eligibility Calculator

 

Our CHC funding eligibility tool is a simplified version of the official NHS funding eligibility assessment, featuring 12 questions designed to determine your healthcare needs or those of your loved one.

 

It’s an accessible, multi-choice questionnaire, so for each question, simply select the option that best describes your or your loved one’s needs.

 

Once you’ve completed the questionnaire, click ‘see results’ for an instant outcome, which is based on the CHC eligibility criteria outlined above. Your result will include an explanation and guidance on next steps.

 

This calculator is not an official decision, only a tool to determine potential outcomes of the official NHS funding eligibility assessment. You can view the official NHS CHC checklist here.

 

Next Steps After Using the CHC Funding Calculator

 

Once you’ve completed the questionnaire, you’ll get an instant outcome based on the answers you’ve provided. They’ll break down as such:

 

Likely Eligible

In this case, request a formal NHS Continuing Healthcare assessment as soon as possible. Your GP or social worker can begin the process.

 

Borderline/Possibly Eligible

In this case, you may qualify for CHC funding, but will likely need to gather supporting evidence (GP letters, care plans, etc) before requesting an assessment.

 

Unlikely Eligible

In this case, your CHC funding request will likely be declined. As such, it may be prudent to explore local authority or private funding options for your care.

Whatever the outcome of your CHC funding eligibility assessment, we can help. We offer free advice on CHC and deliver high-quality care that can be funded either privately or via CHC. Contact us for a free consultation. You can also review care provider standards via the Care Quality Commission (CQC).

 

Frequently Asked Questions

Who is eligible for NHS Continuing Healthcare?

 

CHC eligibility is determined by the nature and severity of your health care needs, broken down into categories including severe, high, moderate, low, and no needs.

 

Typically, CHC funding is awarded through a combination of priority and severe needs, but a mix of complex needs at a lower threshold may also qualify.

 

It’s worth noting that age and financial circumstances are not assessment factors.

 

What if I am not eligible for CHC funding?

If you’re not found eligible for CHC funding, you may still qualify for NHS-funded nursing care if you’re in a nursing home. You may also qualify for means-tested or local authority (i.e. council) support.

 

You also retain the right to request a reassessment if your needs worsen.

Does CHC cover live-in care at home?

Yes. If you qualify, CHC can fund care in any appropriate setting, including live-in care at home. The NHS team will create a care plan based on assessed needs.