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Original data analysis · England · 18 September 2026
NHS Continuing Healthcare referrals over 28 days more than doubled in a year
Care Home Cost Claims analysis of NHS England Q1 2026/27 figures finds 2,229 incomplete standard CHC referrals had already exceeded the 28-day period at quarter-end, compared with 1,076 a year earlier — a rise of 107.2%. The proportion of completed standard referrals finished within 28 days also fell from 75.5% to 67.4%.
Analysis and legal commentary reviewed by Paris Theodorou, Solicitor & Principal · Christodoulos Ltd · SRA 809508
Headline findings
What changed in Q1 2026/27?
The figures point to a materially larger unresolved standard-pathway workload. They do not show why each referral was delayed, whether a delay was avoidable, or whether the person was ultimately found eligible for CHC.
How old was the backlog?
Nearly half of delayed referrals were already 4–12 weeks beyond the 28-day period
| Delay beyond 28 days | Referrals | Share of 2,229 |
|---|---|---|
| Up to 2 further weeks | 531 | 23.8% |
| More than 2 to 4 further weeks | 392 | 17.6% |
| More than 4 to 12 further weeks | 1,075 | 48.2% |
| More than 12 to 26 further weeks | 144 | 6.5% |
| More than 26 further weeks | 87 | 3.9% |
Our calculation: 231 of the 2,229 delayed referrals — 10.4% — were already more than 12 weeks beyond the initial 28-day period. These categories describe additional elapsed time after 28 days, not total waiting time.
The 28-day expectation
What does “over 28 days” actually mean?
The National Framework says that, in most cases, the time between an Integrated Care Board receiving a positive Checklist (or other notice that a full assessment is required) and the eligibility decision should not exceed 28 calendar days.
There can be valid reasons for a longer process, including circumstances where reliable assessment evidence is temporarily unavailable or a person needs time to recover before their needs can be assessed properly. A national delay count therefore cannot, by itself, distinguish justified delay from avoidable administrative delay.
The NHS also says that where a person is ultimately found eligible and the decision took longer than 28 days without justifiable reasons, the ICB should normally refund relevant care costs from the 29th day until the decision date.
Why the figures matter
For families, delay can mean prolonged uncertainty about who should fund care
The data do not establish that every delayed case caused financial loss. But an unresolved CHC decision can leave a family uncertain about whether the NHS, the local authority or the individual should ultimately bear care costs.
Where the standard pathway has passed 28 days, families should keep a dated record of the positive Checklist or referral date, ask what stage the assessment has reached, identify what evidence is outstanding and request a written explanation for any delay. Necessary care should not wait for the funding decision.
Solicitor comment
“The key issue is not simply the number of delayed cases, but how old some of them have become.”
“A 28-day figure can sound abstract until you look at the age profile. Nearly half of the delayed referrals in the Q1 data were already more than four and up to twelve weeks beyond that period, and more than one in ten were beyond it by over twelve weeks. That does not prove fault in an individual case, but it does mean families should know the referral date, what evidence is outstanding and why a decision has not yet been made.”Paris Theodorou, Solicitor & Principal, Christodoulos Ltd
What the data do not prove
Five limits journalists and families should keep in mind
Not an eligibility rate
A delayed referral may later result in either an eligible or not-eligible decision.
Not a count of all CHC waits
The 2,229 figure is the published stock of incomplete standard referrals beyond 28 days at quarter-end.
Fast Track is separate
Fast Track CHC follows a different urgent pathway and should not be mixed into the standard 28-day rate.
No cause is recorded nationally
The aggregate data cannot tell us whether a particular delay was caused by evidence, staffing, coordination or another factor.
Timeliness is not decision quality
A decision inside 28 days can still be disputed; a longer assessment may sometimes be careful and justified.
Methodology
How we calculated the figures
We used NHS England's Q1 2026/27 Continuing Healthcare and NHS-funded Nursing Care management-information measures for standard referrals. The year-on-year increase is calculated from 2,229 incomplete standard referrals beyond 28 days in Q1 2026/27 and 1,076 in Q1 2025/26: (2,229 − 1,076) ÷ 1,076 = 107.2%.
The published within-28-day rate for completed standard referrals was 67.447%, based on 11,435 completions within 28 days out of 16,954 standard referrals completed during the quarter. We round this to 67.4%. The comparable Q1 2025/26 rate was 75.5%, a fall of 8.1 percentage points.
Age-band percentages are our calculations from the five published delayed-referral categories and may not sum perfectly to 100% after rounding. We do not infer individual outcomes, causation or compensation from these aggregate figures.
Primary sources
Official material used
NHS England — NHS Continuing Healthcare and NHS-funded Nursing Care for Q1 2026/27 →NHS England — CHC and FNC statistics and national time series →Department of Health and Social Care — National Framework for NHS Continuing Healthcare →NHS — Continuing Healthcare guidance, including delays and refunds →Suggested citation: Care Home Cost Claims, “NHS Continuing Healthcare referrals over 28 days more than doubled in a year”, analysis reviewed by Paris Theodorou, Solicitor & Principal, Christodoulos Ltd, 18 September 2026.
CHC taking longer than expected?
Get the decision date, evidence and next step clear
If your CHC assessment has been delayed, refused or the reasoning does not match the evidence, send us the Checklist, DST or decision letter. The initial review is free and we will tell you if paid legal work does not appear proportionate.