NHS Continuing Healthcare: who qualifies and how to claim
By CareFinder Team · Published 2026-06-30 · Last reviewed 2026-09-18
NHS Continuing Healthcare is care paid for in full by the NHS for adults whose needs are mainly health needs, called a primary health need. It is not means-tested and can be provided at home or in a care home. In England, ask for a Checklist screening, which leads to a full assessment if positive; people nearing the end of life can be fast-tracked.
NHS Continuing Healthcare is care arranged and paid for in full by the NHS for adults whose needs are mainly health needs, known as a "primary health need". It is not means-tested and can be provided at home or in a care home. In England you claim by asking for a Checklist screening, which leads to a full assessment if positive; people nearing the end of life can be fast-tracked.
This article describes the rules in England. Wales runs a similar Continuing NHS Healthcare scheme through health boards, Scotland replaced Continuing Healthcare in 2015 with hospital-based complex clinical care, and Northern Ireland has its own guidance through the Health and Social Care Trusts.
What is NHS Continuing Healthcare?
If your relative is eligible, the NHS pays for the care and support needed to meet their assessed needs. In a care home, that includes the accommodation and care fees. At home, it covers the care and support needed, though not ordinary living costs such as food, rent or bills. It is arranged by the local integrated care board (ICB), as explained in the NHS guide to Continuing Healthcare.
The rules are set out in the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, published by the Department of Health and Social Care.
Who qualifies?
Eligibility does not depend on a diagnosis. It depends on whether a person's overall needs show a primary health need, judged by four characteristics:
- Nature: the type of needs and the effect on the person.
- Intensity: how severe the needs are and how much support they need.
- Complexity: how the needs interact and how hard they are to manage.
- Unpredictability: how much the needs change and the risks if they are not met promptly.
The 12 care domains
Assessors look at needs in 12 areas, known as care domains:
- breathing
- nutrition
- continence
- skin integrity, including wounds and ulcers
- mobility
- communication
- psychological and emotional needs
- cognition
- behaviour
- drug therapies and medicines
- altered states of consciousness
- other significant care needs
Each is given a level from "no needs" up to "severe" or "priority". According to the NHS, if you have at least one priority need, or severe needs in at least two areas, you can usually expect to be eligible. You may also be eligible with a severe need in one area and other significant needs, or with a mix of high and moderate needs that together show a primary health need.
How does the assessment work?
Step 1: The Checklist
Most people start with a Checklist, a screening tool that a nurse, doctor, social worker or other trained professional can complete, often before hospital discharge or when needs increase. It is designed to screen people in, so a positive Checklist means a full assessment, not guaranteed funding. You can ask for one; if it is not appropriate, you should be told why.
Step 2: The full assessment
A multidisciplinary team of at least two professionals from different health and care professions assesses your relative's needs, using a form called the Decision Support Tool, and makes a recommendation. You and your relative should be invited to take part and have your views recorded. The ICB then makes the decision.
According to the NHS, ICBs will normally decide within 28 days of receiving a completed Checklist or request for a full assessment. If the ICB decides your relative is eligible but has taken longer than 28 days without good reason, it should refund care costs from day 29 until the decision.
Fast track for people nearing the end of life
If your relative's health is deteriorating quickly and they are nearing the end of life, an appropriate clinician can complete the Fast Track Pathway Tool. The NHS says a care package should then be put in place as soon as possible, usually within 48 hours. Ask the GP, ward team or specialist nurse about it.
How do you prepare for the assessment?
- Ask for the Checklist from the GP, hospital discharge team, district nurse, social worker or the ICB.
- Keep a care diary for a few weeks: falls, night-time needs, behaviour, pressure sores, choking, medicines and how often help is needed.
- Collect evidence such as care home records, hospital letters and professional reports. Ask the care home to make sure its records reflect your relative's needs.
- Attend the assessment and make sure needs that are well managed are still recorded. A need that is managed because of skilled care is still a need.
- Ask for the decision and reasons in writing, with a copy of the completed Decision Support Tool.
Independent advice on the process is available free from organisations such as Age UK.
What if your relative is not eligible?
- **NHS-funded nursing care:** in a nursing home, if your relative needs care from a registered nurse, the NHS pays a weekly contribution direct to the home. According to the NHS page on NHS-funded nursing care, the standard rate from 1 April 2026 is £267.68 a week.
- Council support: you can be referred to the council for a needs and financial assessment. In England, for 2026/27, people with capital above £23,250 usually pay the full cost of care themselves.
- A later review: needs can change, so ask for a new Checklist if your relative's health gets worse.
How do you challenge a decision?
- Local resolution. Ask the ICB to review its decision, setting out where you think the evidence was misread. There are time limits, so act promptly.
- Independent review panel. If you still disagree, you can ask NHS England for an independent review. The NHS England guide to the independent review process explains how. Requests are normally expected within six months of the local resolution decision.
- Ombudsman. After that, you can complain to the Parliamentary and Health Service Ombudsman.
What happens once funding is agreed?
- The ICB works with you to agree a care and support package and setting. It can take cost into account when choosing between suitable options.
- In England, people eligible for Continuing Healthcare have the option of a personal health budget, which gives more choice over how care is arranged.
- Needs and the care package are normally reviewed within 3 months and then at least once a year. Eligibility can end if needs change.
- Benefits can be affected. Attendance Allowance usually stops after 28 days if the NHS is paying for a care home place. The State Pension continues.
This is general information. For complex cases, advice from an independent specialist or a solicitor can help, particularly if you are challenging a decision.
Frequently asked questions
Is NHS Continuing Healthcare means-tested?
No. If your relative is eligible, the NHS pays for their assessed care needs whatever their income, savings or property.
Does dementia qualify for Continuing Healthcare?
No diagnosis qualifies on its own. People with dementia can be eligible if their needs, such as behaviour, cognition or risk, are severe, complex or unpredictable enough to show a primary health need.
Can Continuing Healthcare be provided at home?
Yes. It can be provided at home or in a care home. The ICB considers your relative's wishes, and can also take cost and value for money into account when agreeing the setting.
How long does it take?
ICBs normally decide within 28 days of a completed Checklist or request for full assessment. The fast track for people nearing the end of life should usually see care in place within 48 hours.
What is the difference between Continuing Healthcare and NHS-funded nursing care?
Continuing Healthcare pays for all assessed care. NHS-funded nursing care is a weekly contribution towards the registered nursing part of nursing home fees for people who are not eligible for Continuing Healthcare.
Key takeaways
- Continuing Healthcare is fully NHS-funded and not means-tested, for people with a primary health need.
- Eligibility depends on needs across 12 care domains, not a diagnosis.
- Start with a Checklist; ask about the fast track if your relative is nearing the end of life.
- Keep a care diary and attend the assessment to make sure all needs are recorded.
- You can challenge a decision through local resolution, an NHS England independent review, then the Ombudsman.
- Scotland, Wales and Northern Ireland have different arrangements.