NHS continuing healthcare

Some people with long term complex health needs qualify for free care arranged and funded solely by the NHS. This is known as NHS continuing healthcare – sometimes we refer to it as ‘CHC’.

NHS continuing healthcare can be provided in a variety of places outside hospital, such as in your own home or in a care home.

Who is eligible for NHS continuing healthcare?

NHS continuing healthcare is for anyone who is aged 18 years and over who meets the criteria. To find out if you are eligible for NHS continuing healthcare (CHC), you must be assessed by our team of CHC healthcare professionals.

Our CHC assessment team will look at all your care needs in relation to:

  • what help you need
  • how complex your needs are
  • how intense your needs can be
  • how unpredictable they are, including any risks to your health if the right care isn't provided at the right time

Your eligibility for NHS continuing healthcare depends on your assessed needs and not on any particular diagnosis or condition you have. If your needs change then your eligibility for NHS continuing healthcare may change and funding may cease.

COVID-19 and your CHC assessment

The government suspended CHC assessments in March 2020 to help the NHS and social care deal with the COVID-19 (coronavirus) pandemic.

It meant that anyone who required a package of care had it funded by the NHS, without a CHC assessment. Where this happened, people received a letter explaining that it was a temporary arrangement because of the pandemic, and that they would be assessed in the future.

NHS continuing health care assessments restarted on 1 September 2020. This means that we now have to assess everyone who was given NHS COVID-19 funding between 19 March 2020 and 31 August 2020. This assessment could mean that some people will now need to pay for some or all of their care. However, they will still not need to pay for any care they received between 19 March 2020 and 31 August 2020,

Our CHC team will be contacting you directly if you are in this position to make arrangements for you to be assessed.

How do CHC assessments work?

We recognise that NHS Continuing Healthcare (CHC) can appear to be a complex and highly sensitive process, which often affects people at a very uncertain stage of their lives.

So, our CHC team will fully involve you, your family and carers in your assessment and keep you informed, so that your views about your needs and support are at the centre of this process. Our team will also consult your carers and family members if this is appropriate.

We are committed to ensuring you have the opportunity to play as full a role as possible in your assessment and that you receive the support to do this where needed. You could do this by asking a friend or relative to act as your representative and help explain your views.

For anyone who is not able to make a decision about their care on their own, we will closely involve their representative to act on their behalf to ensure their wishes are expressed in the process.

 A decision about eligibility for a full assessment for NHS continuing healthcare should usually be made within 28 days of an initial assessment or request for a full assessment.

However, if you need care urgently – for example, if you have a rapidly deteriorating condition – your assessment may be fast-tracked.

What is a personal healthcare budget?

If you are eligible for NHS funded continuing healthcare, you may also wish to have a personal healthcare budget. Please click here for more information. You can discuss this further with your CHC team.

What happens if I’m not eligible?

If you are not eligible for NHS continuing healthcare you can be referred to your local council who can discuss with you whether you may be eligible for support from them.

If you still have some health needs then the NHS may pay for part of the package of support. This is sometimes known as a ‘joint package’ of care.

If you live in a care home offering nursing care you may be eligible for NHS Funded Nursing Care (FNC).This type of funding is available for people that have registered nursing needs and are receiving their care in a care home with nursing care provision. Please be aware that being a resident in a care home with nursing care provision does not automatically indicate eligibility for FNC.

How do I contact my local CHC team?

Call 0151 459 9444 and choose option one for the Midlands and Lancashire CHC Team who will be able to offer you general advice.

More information and useful links

Our local processes for NHS continuing healthcare are set nationally by government and you can find out more here.

If you'd like further information, the Beacon service provides specialist advice on NHS continuing healthcare and offer 90 minutes of free advice from trained staff. Find out more here.

You can share your experiences and give feedback to Healthwatch Sefton, who work to ensure that health and care services work for the people in Sefton. Find out more here.