In short, NHS Continuing Healthcare (CHC) is a package of fully funded NHS care for adults whose main needs are health needs rather than social care needs. NHS continuing healthcare eligibility is worked out using a short screening tool called the Checklist, and if that is positive, a fuller assessment using the Decision Support Tool. Eligibility depends on having a "primary health need", not on a specific diagnosis.
This guide walks families, case managers and funders through the route from the first Checklist to the full assessment, so you know what may happen and how to prepare.
What is NHS Continuing Healthcare?
NHS Continuing Healthcare is care that is arranged and funded entirely by the NHS for adults aged 18 and over who have significant ongoing health needs. When someone is eligible, the NHS pays for their care, whether that care is given at home or in a care home. There are no means tests and no charges for the person.
CHC is different from local authority social care, which is means-tested. It is also different from NHS-funded nursing care, which is a contribution towards nursing in a care home. According to the NHS, CHC is based on your assessed health needs, not on your condition, your age, or where you live (Last verified June 2026).
For people living with a brain injury, stroke, multiple sclerosis or Parkinson's, this matters because needs can be complex and can change over time. CHC is one of several funding routes. We explain the wider picture in our guide to understanding funding for neuro-rehabilitation.
How is NHS Continuing Healthcare eligibility decided?
NHS continuing healthcare eligibility is decided by whether a person has a "primary health need". This is the key test. It means the main reason someone needs care is to manage a health need, rather than to help with everyday social tasks alone.
There is no list of qualifying conditions. Two people with the same diagnosis can reach different outcomes, because the assessment looks at the nature and complexity of needs, not the label. The Department of Health and Social Care sets out the rules in the National Framework for NHS Continuing Healthcare on gov.uk (Last verified June 2026).
The assessment considers needs across several areas, including:
- Breathing, nutrition and continence
- Mobility and skin condition
- Cognition, behaviour and psychological needs
- Communication and medication
- The risk and unpredictability of those needs
A primary health need is judged on four ideas: the nature of the needs, their intensity, their complexity, and how unpredictable they are. A need that is hard to manage safely, or that changes quickly, carries more weight.
How does the CHC Checklist work?
The CHC Checklist is a short screening tool used to decide whether a full assessment is needed. A nurse, doctor or other health or social care professional usually completes it. It is meant to be inclusive, so the threshold to move forward is deliberately low.
The Checklist scores needs across eleven areas using levels of A, B or C, where A is the highest. You do not need to understand the scoring to take part, but it helps to know what triggers a full assessment. A positive Checklist does not mean someone is eligible. It only means they have the right to a full assessment.
If the Checklist is negative, the person should be told in writing and given the reasons. You can ask for it to be reconsidered if you feel the needs were not fully captured.
To prepare for a Checklist, it helps to:
- Keep a simple diary of daily needs and any changes
- Note any nights that are disturbed and any safety incidents
- List medicines, equipment and support already in place
- Ask for a copy of the completed Checklist
What happens in the full CHC assessment?
If the Checklist is positive, a multidisciplinary team (MDT) carries out a full assessment. This team usually includes at least two professionals from different backgrounds, such as a nurse and a social worker, who know the person's needs.
The MDT uses the Decision Support Tool (DST). The DST looks at twelve "care domains", scoring each from no needs up to priority needs. The team uses these scores, along with their professional judgement, to recommend whether there is a primary health need. According to NICE, good assessment should centre the person and bring together the right professionals.
The person and their family or representative have a right to take part. You can share what daily life is really like, especially the needs that are easy to miss, such as fatigue, fluctuating cognition, or the effort it takes to stay safe. Bringing notes and a calm summary of a typical week can help.
The MDT makes a recommendation, and the integrated care board (ICB) makes the final decision. You should receive the decision and the reasons in writing.
How can families prepare and what if you disagree?
Preparation makes a real difference, because a clear, honest picture of daily needs helps the team see the whole situation. Gather records, keep a needs diary, and ask who is coordinating the process so you have a single point of contact.
It helps to:
- Ask for assessment paperwork in advance
- Request that any key professional who knows the person attends
- Bring someone with you for support and note-taking
- Ask for plain-English explanations of anything that is unclear
If you disagree with a decision, you can ask the ICB to review it. There is a formal process for this, and you can take a complaint further if needed. Funding can also be reviewed over time, because needs change, so a "not eligible" outcome today is not always the final word.
Support like reablement can run alongside these funding conversations. Reablement is support that aims to help someone rebuild daily skills and confidence, whoever is funding the care.
Frequently asked questions
Does a specific diagnosis qualify for CHC?
No. There is no qualifying condition list. Eligibility rests on having a primary health need, judged by the nature, intensity, complexity and unpredictability of the needs.
How long does the CHC process take?
Timescales vary. The NHS aims to make eligibility decisions within a set period after a positive Checklist in most cases, though complex situations can take longer. Ask your coordinator for expected timings.
Is NHS Continuing Healthcare means-tested?
No. CHC is fully funded NHS care and is not means-tested. This is different from local authority social care, which does take finances into account.
Can a CHC decision be reviewed or appealed?
Yes. You can ask the integrated care board to review a decision you disagree with, and eligibility itself is reviewed over time as needs change.
Who completes the assessments?
A health or social care professional usually completes the Checklist. A multidisciplinary team completes the full assessment using the Decision Support Tool.
If you are supporting a relative and want to talk through what reablement could look like alongside a funding decision, please get in touch. We are happy to answer questions at your pace.