What Is NHS Continuing Healthcare Funding?

It is a funding package available from the NHS to cover the full costs of a person’s care requirements. That’s 100% of their care costs, including accommodation. With the average cost of care in a nursing home currently estimated at £550 a week, it’s one of the most valuable services provided by the NHS.

BUT it is only available to people who have what are assessed by the NHS to be primary healthcare needs.

In simple terms, that means those people whose healthcare needs are such, that in normal circumstances they would need to be cared for in hospital long term. But, because this level of healthcare can be provided outside of a hospital, by qualified nurses in a nursing home for example, or by qualified healthcare professionals in a person’s own home, then those people can be moved out of hospital, only because their healthcare needs can be met in these other care environments. On that basis, the NHS pays 100% of the care costs either to the nursing home, or for care at home, because otherwise the person would have to remain in hospital to be cared for.

You can also look to reclaim care costs that have already been paid.

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How Is Funding Assessed?

The NHS has specialist Continuing Healthcare teams who assess a person’s eligibility for funding. The assessment is done using criteria laid down in the NHS Framework and looks at a number of specific areas of care and applies a “score” to a person’s healthcare needs in each area. These “scores” are then added up to determine whether a person is eligible for funding.

The process is carried out in two stages. The first is a Checklist stage where an initial assessment is carried out, if a person passes through this stage then a Full Assessment is carried out looking at the persons care needs in more detail.

Are assessments means tested?

No – It’s very important to understand that these assessments are not means tested. It doesn’t matter how much money a person has to pay for their own care, if they qualify, the NHS will pay 100% of their care costs regardless of how much money they have in savings or investments, or how much their house is worth.

How do you get assessed?

Anyone can request an initial Checklist assessment if they think they may be eligible for funding. You should contact your local NHS Continuing Healthcare co-ordinator to request an assessment, or ask your care home manager to request an assessment from the NHS on your behalf.

Remember, even if you have already been assessed once you can ask for a re-assessment at any time if you believe that persons healthcare needs have changed.

How do I know if someone is likely to be eligible for funding?

It’s very difficult to know if someone will be eligible because the assessment focuses on healthcare needs and not the specific condition that a person may have. The more information you have the easier it is to understand how the assessment process works, which is why we have produced a detailed FREE Guide.

Can I claim back care costs?

Yes. If you think you should have been eligible for NHS Continuing Healthcare funding in the past, you can back the care costs you have paid dating back to 31st March 2012.

Care cost paid prior to 31st March 2012 cannot be reclaimed because the Government set a deadline for registering claims prior to that cut off date which has now passed. For more information about claiming back care costs get our FREE Guide

See Martin Lewis talking to the BBC about reclaiming care costs.

5 Steps to secure NHS Continuing Healthcare Funding

1. Get our FREE Guide to understand how NHS Continuing Healthcare Funding works.
2. Call for a FREE Initial Assessment
3. Request an initial Checklist Assessment from the NHS and make sure you are there when the assessment takes place. If you like, we can help by sending one of our experienced nurses to do our own Checklist Review first.
4. If the Checklist Assessment is successful a more detailed Full Assessment will take place, make sure you are there when this happens. We can help by sending one of our own experienced nurses to support you at the Full Assessment.
5. If you disagree with the decision you can Appeal, ask us for advice on how our expert solicitors can help.

Client Testimonial

“Dear Hannah, We really appreciate all your hard work in helping us win the case and the monies from the NHS…..£26,596”

Client Testimonial

“Dear Jonathan, thank you so much for your patience and persistence claiming back funding for my late mother’s care costs…”

Case Study

Barry Pritchard, from Salisbury,  is an ex-police officer who say that the only reason his father received the NHS funding is because he got lawyers involved…

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Case Study

It was a worrying moment for Edward Battersby when the NHS Continuing Healthcare Funding his 93 year old mother was receiving was to be re-assessed. This meant there was a chance funding could be removed so they got in touch with us…

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Case Study

Brian Marshall has a cheque on the way to him for £40,000 as a result of the fact his father, wrongly, had to pay for care fees. Brian, 62, felt very strongly about this stating this his father had worked his whole life and paid into the system but was wrongly refused help when he needed it most.

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Case Study

Peter Shaw is a retired teacher from Pickering in North Yorkshire. He had to sell his mother’s home in order to pay for her care home fees. Then, not long after her funeral he discovered that she should have received free funding from the NHS and was entitled to NHS Continuing Healthcare Funding all along…

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Continuing Health Care


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