NHS Continuing Healthcare¶
NHS Continuing Healthcare (CHC) is a package of care arranged and funded entirely by the NHS for people with a "primary health need" — care needs that are sufficiently complex, intense, or unpredictable that the responsibility for them rests with health services rather than with social services. CHC is not means-tested: the person's savings, property, and income are irrelevant. Where someone qualifies, the NHS pays 100% of their care home fees or in-home care costs. [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]
Eligibility is assessed against four key indicators: the nature of the person's needs, the intensity, the complexity, and the unpredictability. The assessment uses a National Framework Decision Support Tool that scores need across 12 care domains (mobility, nutrition, continence, skin integrity, breathing, communication, psychological needs, cognition, behaviour, drug therapies, altered states of consciousness, and other significant needs). A multi-disciplinary team — typically including a nurse, social worker, and other clinicians — runs the assessment. There is no specific medical diagnosis that automatically qualifies; eligibility is a judgement on the totality of need. [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]
Why it matters after a death: CHC is widely under-assessed and under-awarded. The Parliamentary and Health Service Ombudsman has repeatedly criticised the inconsistency of decisions. Many care home residents with substantial health needs are never formally assessed, or are assessed and found ineligible on grounds that subsequent review establishes were wrong. Where the person who has died was paying their own care home fees and was never properly assessed, the estate can pursue a retrospective CHC claim against the local Integrated Care Board (ICB) for a refund of fees plus interest. [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]
Retrospective claims can be made for care received from 1 April 2012 onwards (claims for earlier care had to be made by March 2013 and are now out of time). There is no statutory deadline for post-2012 claims, although evidence becomes harder to assemble as records age. The executor applies to the local ICB; the ICB convenes a panel to review the medical and care-home records and decide whether the person met CHC eligibility during the period in question. Successful claims produce 100% refunds of the fees paid plus interest at the Retail Prices Index rate from April 2015 onwards. [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]
Funded Nursing Care (FNC) is a smaller, separate NHS contribution paid directly to nursing homes (not residential care homes) for the registered-nurse component of care. Standard rate £254.06 per week from April 2025, rising to £267.68 per week from April 2026. Higher rate £349.50/£368.24 per week applies to a small number of pre-2007 residents. FNC is paid for nursing home residents who do not meet CHC eligibility but still receive registered nursing care. [source: gov-uk/nhs-continuing-healthcare-2026-04-30.html]
Scotland does not use NHS CHC. Personal care has been provided free of charge to all adults assessed as needing it since April 2019 (extended from over-65s under "Frank's Law"). The free personal care covers up to a defined weekly amount; accommodation and food costs are still payable. The Scottish system is administratively simpler than the English/Welsh CHC framework but covers a narrower range of care.
Last verified: 30 April 2026 against NHS Continuing Healthcare guidance.