Understanding NHS Continuing Healthcare
A plain-English guide to the main stages of the CHC process.
The National Framework
NHS Continuing Healthcare (CHC) is a package of care arranged and funded solely by the NHS for individuals who have a primary health need. The process is set out in the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care.
Key stages
- Checklist: a screening tool used to decide whether a full assessment is needed.
- Decision Support Tool (DST): a detailed assessment across multiple domains of need.
- Recommendation: the multidisciplinary team makes a recommendation to the Integrated Care Board (ICB).
- ICB decision and review: the ICB confirms the decision. If you disagree, there are routes to challenge it.
The CHC journey at a glance
A simplified view of how most NHS Continuing Healthcare cases progress from first concerns to a final decision.
Initial concerns about funding
Health or social care professionals – or the family – identify that the person’s needs may be more than social care alone, and raise CHC as a potential option.
Checklist completed
A trained professional completes the Checklist. If it is “positive”, the person should move forward to a full CHC assessment using the Decision Support Tool (DST).
DST and multidisciplinary team (MDT)
The MDT reviews evidence from health and care records and scores each domain of need. They then make a recommendation about whether the person has a primary health need.
ICB decision and communication
The Integrated Care Board (ICB) makes the final decision, taking the MDT’s recommendation into account and writing to confirm the outcome and reasons.
Review, challenge or appeal
If you disagree with the outcome, there are local review and national appeal routes. Strong, well-organised evidence is key at this stage.
We can guide you through each stage
Whether you are just starting the process or already have a decision that you are concerned about, we can help you plan realistic next steps.
