NHS continuing healthcare and NHS-funded nursing care

NHS continuing healthcare may be available for your clients who have significant, long-term healthcare needs and are receiving care in a care home or in their own home. Any of your clients eligible for NHS continuing healthcare will have all the costs of their care paid for by the NHS. It doesn’t matter how much they're earning or what capital they have. It's not a means-tested benefit.

Applying for NHS continuing healthcare

To apply, your client must have long-term health needs which require care. The process is two-stage:

  • Initial assessment (Checklist) - This involves the completion of a short checklist undertaken by a social care worker or health worker. If the checklist is approved, the process moves to the next stage.
  • Full assessment - This stage includes a full assessment of the needs of the person. A multi-disciplinary team use this information to complete a decision support tool. This informs the decision-making body. 

When an application is approved, a package of care and support is agreed. If an application is unsuccessful, there is an appeal process. If the original decision is upheld, the matter can be referred to the local authority. They'll consider whether someone is eligible for care and support. Their assessment is means-tested. 

NHS-funded nursing care

If your client doesn't qualify for NHS continuing healthcare, but lives in a nursing home, they could be eligible for NHS-funded nursing care. Assuming the full assessment for NHS continuing healthcare has been carried out, a separate assessment isn’t required.

If someone is eligible for NHS-funded nursing care, payment is paid direct to the nursing home to cover the costs of their nursing care. If NHS-funded nursing care isn’t approved, there is a review process.

What action should be taken?

If your client believes they could be eligible for NHS continuing healthcare, the first step is to approach their GP.

NHS continuing healthcare

For full details on NHS continuing healthcare.

Funded nursing care

For full details on funded nursing care.

NHS continuing healthcare - Challenging the decision

For full details on challenging the decision for NHS continuing healthcare.

Useful sites

We've selected a range of articles and further information on NHS continuing healthcare.

Information researched and accurate 21 June 2019. Not to be relied upon by advisers or their clients.