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Continuing health care (CHC)

What is NHS continuing healthcare (CHC)?

NHS continuing healthcare is the name given to care and support which is arranged and paid for by the NHS. It's also known as CHC funding. It's for people who have ongoing healthcare needs and may include social care costs which would normally be paid for by an individual or the council. You can receive NHS continuing healthcare if you are living in your own home, in a care home or in hospital.

NHS continuing healthcare is free, unlike support provided by a local authority, for which a financial charge may be made depending on your income and savings.

If you are eligible for NHS continuing healthcare and you live in your own home, this means that the NHS will pay for your care fees in addition to providing you with a case manager. Care fees can be paid directly or via a Personal Health Budget (PHB), which is similar to a Direct Payment (DP). The NHS may also pay for other care needs such as help with bathing and dressing, food preparation and shopping if these are part of the assessed needs.

If you live in a care home, NHS continuing healthcare can pay for your care home fees, including board and accommodation.

In Dorset, NHS CHC is provided via Dorset Clinical Commissioning Group.

The NHS provides further information.

Eligibility

NHS continuing healthcare (CHC) is available to people over 18 years old who have been assessed as having a certain level of care need because of illness or disability.

Someone is eligible for CHC if it can be said that the main aspects or majority part of the care they require is focused on addressing and/or preventing health needs. It is not about the reason why an individual requires care or support, nor is it based on their diagnosis; it is about the level and type of their overall actual day-to-day care needs taken in their totality. If you're eligible for NHS continuing healthcare, your care will be funded by the NHS. The care provided will be reviewed regularly and if your care needs change, the funding arrangements may also change.

The easiest way to know if you are eligible for free NHS continuing healthcare is to ask your GP, community nurse, other health professional or social care worker to arrange an assessment.

If you are not eligible

You may be eligible for NHS-funded nursing care (FNC) if you are not eligible for NHS continuing healthcare but you have been assessed as having care needs.

The council may be responsible for assessing your care needs and providing services if you are eligible, if you or the person you care for does not qualify for NHS continuing healthcare.

NHS-funded nursing care is care provided by a registered nurse for people who live in a care home.

NHS-funded nursing care is paid directly to the care home where the person you care for is getting nursing – it covers the cost of the nursing only.

You may be eligible for NHS-funded nursing care if:

  • you're not eligible for NHS continuing healthcare but have been assessed as needing care from a registered nurse
  • you live in a nursing home

Most people don't need a separate assessment for NHS-funded nursing care. However, if you do need an assessment or you haven't already had one, your clinical commissioning group (CCG) can arrange an assessment for you. Find your local CCG.

Funded Nursing Care is non-means tested.

Continuing healthcare assessment

Step 1 - initial screening

First of all, a CHC checklist will be completed with you to see if you are likely to be eligible for CHC funding. This is usually carried out in hospital or at home by a nurse, doctor or other health care professional or social care worker.

They will assess your general health and care needs and the checklist will cover:

  • behaviour
  • cognition (understanding)
  • communication
  • psychological and emotional needs
  • mobility
  • nutrition (food and drink)
  • continence
  • skin including wounds and ulcers
  • breathing
  • symptom control through drug therapies and medication
  • conditions that affect consciousness such as seizures or TIA (mini stroke)
  • other significant care needs

Fast track assessment

Please note that if your health, or that of someone you care for, seems to be getting worse quite quickly, ask your doctor, nurse, occupational therapist or other health professional about getting a CHC fast track assessment.

Step 2 - the assessment

If the CHC checklist indicates that you may meet the criteria for CHC funding, a more detailed assessment will be carried out. This will be by a team of two or more health and social care professionals who are involved in your care.

The team will use the same areas as the CHC checklist above but will go into a lot more detail.