Care & support · England
NHS money for your care
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This guide explains adult care funding in England.
The adult rules start when you are 18.
What CHC means
Some people need a lot of ongoing care.
The NHS may pay for their assessed care package.
This is called NHS Continuing Healthcare, or CHC.
The decision is about your needs.
It is not about your savings or owning a home.
A learning disability does not automatically mean you qualify.
Ask your doctor, nurse or social worker about CHC.
The assessment
A Checklist usually comes first.
It helps decide whether you need a full assessment.
You can have help to explain your needs.
Explain the care you need during daytime and at night.
A team looks closely at your needs.
The team suggests whether you should get funding.
The funding decision
Your integrated care board makes the final funding decision.
This NHS organisation is called an ICB.
Ask for the decision and reasons in writing.
Ask when you should hear back.
Some people become very ill quickly.
They may be getting near the end of life.
Ask their doctor or nurse about the faster funding route.
Planning and checking your care
You should help plan your care.
Say what matters to you and where you want support.
Your care plan should be reviewed.
You can ask for a review if your needs change.
You can challenge a decision you disagree with.
Different problems use different challenge routes.
Children use a different continuing care process.
Plan ahead before moving to adult services.
What you can do next
You can ask: Please consider me for CHC.
Please explain the next steps in a way I understand.
Read the NHS funding guide Web pageThis link opens another website.
It may use harder words.
More useful links
- Checklist forms and guidance Web page
Official screening forms, including an accessible version.
- Decision Support Tool Web page
Official assessment evidence tool and accessible versions.
- Independent review information Web page
NHS England explains review arrangements and regional contacts.
- Find your ICB continuing healthcare team Web page
Use the local NHS directory, then ask for the CHC team.
- Personal health budgets and CHC Web page
Choices about planning and organising your funded support.
- Official Easy Read CHC information Web pageEasy Read
An illustrated government explanation of continuing healthcare.
These links open other websites.
They may use harder words.
NHS Continuing Healthcare funding
How to ask for NHS care funding, who assesses and decides, and the routes for checking or challenging a decision.
Adults aged 18 and over · England · Separate children's pathway explained
What the funding covers
NHS Continuing Healthcare, often called CHC, is for adults aged 18 and over who have a primary health need. The NHS arranges and pays for their assessed package of health and care support, usually at home or in a care home. It is not means-tested: income, savings and home ownership do not decide eligibility. Having a learning disability or a particular medical condition does not automatically qualify or exclude someone.
How needs are considered
Assessors consider the nature of the needs, their intensity, how complex they are, and how unpredictable they can be. They look at needs together, including how they interact. Describe support throughout the day and night, what staff do, and what could happen without that support. A need should not disappear from consideration just because good care currently manages it. Describe the care actually needed and delivered. Do not score every condition as though effective medication or routine care had been removed; the active support and monitoring still need to be recognised.
What the four characteristics mean
Nature means the kind of needs and care required. Intensity concerns the amount, severity and continuity of support. Complexity concerns interactions between needs and the skills needed to manage them. Unpredictability concerns changing needs and the consequences of care being late or missing. One characteristic, or several together, may establish a primary health need. The decision looks at the whole picture. It is not decided by a diagnosis, a simple numerical total, or the fact that relatives or support workers deliver care.
Checklist and full assessment
Ask your GP, nurse, social worker or local NHS continuing healthcare team about assessment. A Checklist is an initial screening step, not the full assessment or a funding award. After a full assessment of needs, a multidisciplinary team brings evidence together using the Decision Support Tool, or DST. The local integrated care board, called the ICB, makes the eligibility decision. Ask for accessible information, copies of records and support from someone you choose.
Asking for CHC funding
You or someone helping you can contact your GP, nurse, social worker or ICB continuing healthcare team. Explain why your ongoing needs may require CHC assessment. Give a few concrete examples and ask what happens next, who will contact you and when. You do not need to wait until your savings run out or until you live in a nursing home. If screening is considered unnecessary, ask for the recorded reasons and what other care assessment or support will be offered.
Who assesses and who decides
The ICB should appoint a coordinator. The multidisciplinary team, or MDT, normally brings together health and social care professionals who know your needs. The minimum is two different healthcare professions, or a healthcare professional and a person responsible for Care Act needs assessments. The MDT completes the DST after a comprehensive needs assessment and recommends an outcome. The ICB makes the final eligibility decision; it should normally follow the recommendation. Departures require exceptional circumstances and clear reasons. Ask for the completed DST, recommendation and decision.
How long the decision should take
In most cases the eligibility decision should be made within 28 calendar days after the ICB receives a positive Checklist, or other notification that a full eligibility assessment is needed. This is not an unconditional deadline running from your first enquiry. Valid and unavoidable delays should be explained. The usual 28-day timescale does not apply to young people being assessed before transfer to adult services. Ask the coordinator to confirm the starting date, next steps and interim support. You should not be left without appropriate care while waiting.
Taking part, consent and capacity
Ask for a supporter, communication aids, Easy Read information, breaks or a different meeting format. Difficulty speaking does not mean someone cannot decide. Under current guidance, the professional CHC assessment itself does not depend on consent. Consent is needed for relevant physical examinations where the person can consent, and explicit permission is normally needed to share personal information with family, friends or other representatives. If someone lacks capacity for a particular decision, the Mental Capacity Act must be followed. Being next of kin does not automatically authorise every decision.
When help is needed quickly
A suitable doctor or registered nurse can use the fast-track pathway where a condition is rapidly deteriorating and the person may be entering a terminal phase. This replaces the Checklist and DST process. There is no fixed rule requiring a particular number of days or weeks of life remaining. Ask the treating team to consider the criteria promptly.
Reviews and disagreements
Care is normally reviewed within three months, then at least annually. If you disagree with eligibility, ask for the decision and reasons in writing. Start with the ICB's local resolution process; unresolved eligibility disputes can go to NHS England for independent review. Ask about deadlines immediately. A negative Checklist can also be reconsidered by the ICB.
Different funding routes
NHS-funded nursing care, or FNC, is different: it contributes to registered nursing care in a nursing home for eligible people who do not qualify for CHC. It does not fund the whole care package. Children and young people under 18 have a separate continuing care framework. That support may form part of a jointly arranged health, education and social care package; adult CHC rules do not simply carry across. Plan the move to adult services early.
Your funded care plan and choices
If eligible, the ICB arranges a package addressing assessed health and associated care needs. Ask for a written plan covering what staff do, when support happens, necessary skills, equipment, emergencies and your own goals. Your preferences about home, relationships and everyday life should be considered. CHC does not guarantee every preferred provider or arrangement. Adults eligible for CHC have a right to a personal health budget; ask how it can work for you. It need not mean receiving cash or employing staff yourself.
Reviews should examine whether care meets your needs
A review is normally held within three months of the eligibility decision, then at least annually. Its main focus is the care plan. A full reassessment of eligibility may be needed if there is evidence of significant changed needs. Stable health resulting from skilled support does not itself mean the need for support has gone. Ask for any proposed change, reasons, consultation and arrangements to prevent a gap in care in writing.
Choosing the right challenge route
A negative Checklist can be reconsidered by the ICB. A full eligibility decision uses local resolution, then NHS England independent review if unresolved. Problems about the amount, location or quality of an awarded care package generally use the NHS complaints procedure instead. Use the linked challenge guide to identify the route, evidence and deadlines. An appeal does not automatically preserve an existing funding award.
Words you could use
“Please explain whether I should have a continuing healthcare assessment. I need information I can understand and support to describe my needs.”
More useful links
- Checklist forms and guidance Web page
Official screening forms, including an accessible version.
- Decision Support Tool Web page
Official assessment evidence tool and accessible versions.
- Independent review information Web page
NHS England explains review arrangements and regional contacts.
- Find your ICB continuing healthcare team Web page
Use the local NHS directory, then ask for the CHC team.
- Personal health budgets and CHC Web page
Choices about planning and organising your funded support.
- Official Easy Read CHC information Web pageEasy Read
An illustrated government explanation of continuing healthcare.
These links open other websites.
They may use harder words.
Where the information comes from
Links checked 1 November 2026.
These links open other websites.
They may use harder words.
- NHS: continuing healthcare Web page
Eligibility, reviews and the difference from NHS-funded nursing care.
- DHSC: national CHC framework Web page
Adult funding principles and assessment of a primary health need.
- DHSC: Checklist guidance Web page
Screening, involvement and reconsideration; updated 20 October 2026.
- DHSC: Decision Support Tool guidance Web page
Multidisciplinary evidence and decisions; updated 22 October 2026.
- DHSC: fast-track guidance Web page
Clinical criteria and no fixed life-expectancy threshold; updated 20 October 2026.
- NHS England: continuing healthcare reviews Web page
Local resolution and independent review.
- DHSC: children's continuing care framework Web page
The separate pathway for children and young people under 18.
- DHSC: public CHC information Web page
28-day starting point, care planning, reviews and challenge routes.
- NHS England: personal health budgets Web page
Right to a personal health budget for eligible adults, including fast-track funding.
- NHS: funded nursing care Web page
Separate nursing-home contribution and CHC consideration first.