What is NHS continuing healthcare?
NHS continuing healthcare is a package of care arranged and funded solely by the NHS. It is also known as NHS continuing care, NHS CHC and fully-funded NHS care.
NHS Continuing healthcare is awarded when a person is classed as having a ‘primary health need’, meaning their care needs should be met and funded by the NHS. Most people requiring care and support are classed as primarily having social care needs, which can be met and funded by adult social care
What is the National framework for NHS continuing healthcare?
The Department of Health produced guidance that sets out a system for deciding eligibility for NHS continuing healthcare. This is called the National framework for NHS continuing healthcare and NHS-funded nursing care.
The Framework sets out the factors that are considered to decide whether someone meets the criteria for NHS continuing healthcare
Alzheimer's Society campaigned for many years for national eligibility criteria for NHS continuing healthcare and therefore welcomed the introduction of the Framework.
However, NHS England do not record diagnosis details in their statistics. We have no figures for how many people with dementia are successful in claiming CHC, compared to how many are turned down. We do know that applicants experiences can vary, with notable discrepancies from the length of process to the overall amount of successful claims in each geographical area.
When does the NHS pay for care?
Our booklet When does the NHS pay for care? explains what NHS continuing healthcare is, how to get an assessment and how to appeal if you think you have been wrongly charged for care.
Applying for NHS continuing healthcare is not an easy process to go through or to understand. Eligibility is based on an individual’s healthcare need not a diagnosis and we cannot tell you whether a person with dementia will be eligible for NHS continuing healthcare.
The guidance applies to people in England. Wales has its own guidance which is very similar but much will also be applicable to people in other parts of the UK.
Receive your copy of our free booklet
Read our booklet for more information on what NHS continuing healthcare is, who can get it, and how assessments are carried out.
If someone is turned down for NHS continuing healthcare, an appeal can be made against the decision. In March 2012 the Department of Health announced some changes to timescales for appealing NHS continuing care decisions.
From 1 April 2012 people were given 6 months from the date of a decision to begin an appeal with the integrated care board (ICB) concerned.
Do I need to pay to succeed with a CHC claim?
A solicitor or representative is not needed to make a claim, or appeal against a decision. Alzheimer’s Society provide free information and advice to people wishing to appeal NHS continuing healthcare cases, contained in our booklet When does the NHS pay for care?.
Although a solicitor is not needed, some people choose to pay for professional expertise. Having support from someone with knowledge of the framework guiding you through the process can be advantageous, but success is still not a guarantee.
There are many specialist organisations available if you choose to pay, we cannot make recommendations. If you are considering this, please ensure you get clear up front costs.
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