How is CHC eligibility decided?

First a CHC Checklist is completed (often by a nurse or social worker). If positive, a Multidisciplinary Team carries out a full Decision Support Tool (DST) assessment. The Integrated Care Board (ICB) then makes the final decision, usually within 28 days of the Checklist.

What is fast-track CHC?

Fast-track CHC is for people who are rapidly deteriorating and may be entering the final stages of life. A clinician completes a single short form and care should be in place within 48 hours, with no full DST required.

What if my relative is refused CHC?

You have the right to ask the Integrated Care Board for a Local Resolution Meeting, then appeal to NHS England's Independent Review Panel. Many initial refusals are overturned at one of these stages — gather the original DST scores and detailed evidence of needs.

Does CHC apply to people in their own home?

Yes. CHC funding can be used for care in any setting — care home, nursing home or the family home. Care delivered at home through CHC is sometimes called a Personal Health Budget.

Can I claim CHC retrospectively?

Previously, families could claim CHC for periods when fees had already been paid. NHS England closed that scheme to new previously-unassessed periods after 31 March 2013, but you can still appeal a recent refusal and seek a refund if you win.

Yes — eligibility is reviewed at three months and then annually. If needs reduce significantly, CHC can be withdrawn and care reverts to social care funding. You have the right to challenge a withdrawal decision.

NHS Continuing Healthcare: full guide

Q: Who qualifies for CHC?

Eligibility depends on a 'primary health need' assessed across 12 care domains (such as cognition, behaviour, breathing, mobility, medication and skin). Diagnosis alone doesn't qualify — it's the nature, intensity, complexity and unpredictability of needs that matters.

NHS Continuing Healthcare (CHC) is fully funded NHS care for people with complex health needs. If you qualify, the NHS pays all your care costs — including care home fees and care at home. Eligibility depends on a needs assessment, not age or diagnosis.

Last reviewed: 15 April 2026·Reviewed by: CareGuide UK Editorial Team, clinically reviewed

What NHS Continuing Healthcare is

NHS Continuing Healthcare (often shortened to CHC) is a package of care funded entirely by the NHS for adults whose ongoing care needs are primarily health-related, rather than primarily social. CHC is not means-tested. If your relative is eligible, the NHS pays the full cost of their care — whether that's in a care home, nursing home, or their own home — and you don't pay a penny toward the care itself.

Who qualifies for CHC

There's no list of conditions that automatically qualify. Instead, eligibility hinges on whether your relative has a primary health need, judged across 12 care domains:

Behaviour
Cognition
Psychological and emotional needs
Communication
Mobility
Nutrition (food and drink)
Continence
Skin (including tissue viability)
Breathing
Drug therapies and medication
Altered states of consciousness
Other significant care needs

Each domain is scored from "no needs" to "priority". Eligibility usually requires either at least one "priority" score, or two or more "severe" scores, or a combination of high scores that, in combination, demonstrate a primary health need.

How the assessment works

Step 1: The CHC Checklist

The Checklist is a short screening tool, usually completed by a nurse or social worker. If the Checklist is positive, your relative is referred for a full assessment. If it's negative, you can still ask for a full assessment if you disagree.

Step 2: The Decision Support Tool (DST)

A multidisciplinary team (usually a nurse, social worker and other clinicians involved in care) meets to score the 12 care domains, ideally with input from the person and their family. This produces a recommendation that goes to the Integrated Care Board.

Step 3: The decision

The ICB makes the final decision and must complete it within 28 days of the positive Checklist. You'll receive a written decision with the DST scores attached.

Try our CHC eligibility checker

Not sure if your relative might qualify? Our free CHC eligibility checker walks through the 12 domains and gives you an indication in under five minutes — no sign-up required.

What to do if you're refused

Many families are refused CHC at the first attempt. You have a clear, two-stage appeal route:

Local resolution — request a meeting with the Integrated Care Board to discuss the DST scores. Bring detailed evidence (care notes, GP letters, hospital reports).
Independent Review Panel — if local resolution fails, you can escalate to NHS England's Independent Review Panel within six months of the local decision.

Many initial refusals are overturned. If you'd like a specialist solicitor to help, we can refer you to a regulated firm with CHC experience.

How to appeal a CHC refusal — your rights and the process

If your relative has been refused NHS Continuing Healthcare, you have a clear legal right to challenge that decision. Many refusals are overturned on appeal — particularly where the Decision Support Tool was scored incorrectly, the family was not properly involved, or the multidisciplinary team was not properly constituted.

The formal appeal process runs through Local Resolution at your Integrated Care Board, then escalates to an Independent Review Panel hearing convened by NHS England, and ultimately to the Parliamentary and Health Service Ombudsman. Each stage has strict time limits — most importantly, the 6-month window to request Local Resolution after the original decision.

Read our full CHC appeals guide →

Fast-track CHC

If your relative is rapidly deteriorating and may be entering the final stages of life, a clinician (often a hospital consultant or palliative care team) can complete a fast-track pathway tool. There's no full DST — care should be in place within 48 hours. If your relative is in hospital and being discharged with end-of-life needs, ask the discharge team specifically about fast-track CHC.

How to apply

Ask the GP, district nurse, hospital discharge team, or social worker to complete a CHC Checklist.
If the Checklist is positive, the Integrated Care Board will arrange a full DST assessment.
Make sure the family is invited to the DST meeting and contribute evidence.
Get the written decision and DST scores. If refused, start the appeal process within the timescales given.

Were you already paying for care that should have been funded by the NHS?

If your relative received care in the past — or has been self-funding or paying through the local authority — and their health needs at the time suggest they may have qualified for CHC, you may be entitled to claim those fees back. Retrospective CHC claims can recover significant sums.

Find out about care fee reclaim →

Frequently asked questions

NHS Continuing Healthcare (CHC) is a package of care funded entirely by the NHS for adults whose care needs are primarily health-related. If awarded, the NHS pays for the full cost of care — including a care home or care at home — and there is no means test.