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So how should it work?

To be eligible for NHS continuing healthcare, you must be assessed by a team of healthcare professionals (a "multidisciplinary team"). The team will look at all your health care needs and relate them to:

  • what help you need

  • how complex your needs are

  • how intense or severe 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

 

Whilst there's no legal definition of a health need - in the context of NHS Continuing Healthcare - in general terms such a need is one related to the treatment, control, management or prevention of a disease, illness, injury or disability, and the care or aftercare of a person with these needs (whether or not the tasks involved have to be carried out by a health professional).

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

You should be fully involved in the assessment process and kept informed and have your views about your needs and support taken into account. Carers and family members should also be consulted where appropriate.

A decision about eligibility should usually be made within 28 days of it being decided that the person needs a full assessment for NHS continuing healthcare.

If you aren't eligible for NHS continuing healthcare, you can be referred to your local authority 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.

Information NHS England  website last reviewed October 2018

For more information about the NHS clinical framework for CHC click here