Understanding CHC
How the assessment works
NHS Continuing Healthcare is a package of care funded entirely by the NHS. It is not means tested. It does not depend on a diagnosis, on savings, or on where someone is cared for. It depends on one thing: whether the care they need is judged to be primarily a health need.
That judgement is reached through an assessment, and the assessment is where most families find themselves lost. This page sets out what is actually being measured, and why sound cases are so often refused.
The Decision Support Tool
Eligibility is decided on twelve care domains
Not on a diagnosis, and not on savings. Each domain is scored fromNo needs up to a ceiling that differs by domain. Understanding this grid is usually the difference between a decision that sticks and one that gets overturned.
What the assessment looks at
The board must look at the overall picture — the nature of the needs, their intensity, their complexity and how unpredictable they are — rather than counting boxes. Whether that adds up to a primary health need is a clinical judgement, and it is the assessors’ to make.
Select a domain to see what it covers →
Why the score is not the whole story
It is tempting to read the grid above and conclude you can work out the answer yourself. In practice it rarely works that way, and this is the single most common reason a strong case is lost.
The assessment also has to weigh the whole picture together: thenature of the needs, their intensity, theircomplexity, and how unpredictable they are. The way evidence is recorded and presented can make a significant difference to how a person’s needs are understood and assessed.
This is why we do not screen anyone out on their scores. We look at the evidence that was available at the time of the assessment, and whether it was read properly.