NHS Continuing Healthcare (CHC): a plain guide

In short: If your needs are mainly health needs, the NHS may pay for all your care. This is called CHC.

A friendly drawing of a heart with a medical cross, held by two hands.

Written by someone who has been through these claims and appeals, for people going through them now. CHC can be very hard to get. This guide is honest about that, and shows you each step.

In short

CHC means the NHS pays for all of your care, if your main need is a health need.
It is for adults. It can be at home or in a care home.
It is based on your needs, not your illness or your money.
First a short checklist. Then, maybe, a full assessment.
If the answer is no, you can challenge it. It is free.

NHS Continuing Healthcare guide: Start here · Checklist, assessment and the 12 areas · Evidence and appeals · Should I pay a firm? · Free printable checklist

You can do all of this yourself, for free. You do not need a solicitor or a paid firm to ask for an assessment, send evidence or appeal. Free help: Beacon (free CHC advice line 0345 548 0300, named on the NHS website) and Age UK Advice Line (free, 0800 678 1602).

What is CHC?

CHC is a package of care that the NHS arranges and pays for in full. It is for adults with a "primary health need". This means your care is mainly about your health. It is not means-tested. Your savings and house do not count. See NHS: continuing healthcare.

If you get CHC in a care home, the NHS pays the fees, including the room and food. At home, it pays for the care you are assessed as needing. You may be able to have a personal health budget.

Why it is hard

Many people are told no. Decisions can feel unfair. Records can be thin. Meetings can feel rushed. This does not mean you should give up. Good evidence makes a big difference. So does knowing the rules.

The steps

Checklist. A short screening tool. If it is positive, you get a full assessment. Read more.
Full assessment. At least 2 professionals look at 12 areas of need, using the Decision Support Tool.
Decision. The local NHS (your ICB) decides. This should usually happen within 28 days of the checklist.
Review. If you get CHC, it is checked after 3 months, then at least once a year.

Fast track: if someone is getting worse quickly and near the end of life, care should be put in place quickly, usually within 48 hours. No checklist is needed.

Delays: if the ICB takes longer than 28 days without a good reason, and you are found eligible, it should refund care costs from day 29.

If you do not get CHC

NHS-funded nursing care (FNC). If you live in a care home with nursing and need a nurse, the NHS pays the home towards nursing. In England from 1 April 2026 it is £267.68 a week. A higher rate of £368.24 is only for some people who moved in before 1 October 2007. See NHS: NHS-funded nursing care.
Joint package. The NHS may pay for part of your care, and the council the rest. This is called a joint package of care. Ask about it if you have some health needs.
Council help. You can get a council care assessment. Use our find your council tool.
Challenge it. You can ask for a review. See evidence and appeals.

Scotland, Wales and Northern Ireland

Scotland: there is no CHC. It was replaced by Hospital Based Complex Clinical Care. Personal and nursing care for adults is free if assessed as needed. See gov.scot: free personal and nursing care.
Wales: it is called Continuing NHS Healthcare. It has its own Welsh framework, used since 1 April 2022. See gov.wales: Continuing NHS Healthcare framework.
Northern Ireland: rules are different. Ask your Health and Social Care Trust. See nidirect: HSC Trusts.

Official sources

← Back to NHS care (CHC)

Information only. This page explains official guidance in plain English. It is not legal or medical advice. Rules can change. For advice about your own case, contact Citizens Advice or another free adviser.

Where this applies: England. Scotland, Wales and Northern Ireland have different rules.

Written by Social Care Made Easy. Last checked: 25 October 2026.