Nature
What kind of needs exist?
The type and quality of the needs, the interventions required and what may happen if care is delayed or absent.
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NHS Continuing Healthcare guide
Who qualifies for NHS Continuing Healthcare?
A person may qualify for NHS Continuing Healthcare (CHC) if their overall needs amount to a primary health need. CHC is not means-tested, no diagnosis automatically qualifies, and eligibility depends on the nature, intensity, complexity and unpredictability of the person’s actual day-to-day needs.
Reviewed by Paris Theodorou, Solicitor & Principal · Theodorous · SRA 809508 · Updated 17 September 2026
What is the legal test?
The National Framework says CHC is for adults aged 18 or over who are assessed as having a primary health need. The assessment looks at the totality of the person’s needs rather than the diagnosis that caused them.
Intensity
How much care is required?
The severity, frequency, continuity and quantity of care, including interventions across the day and night.
Complexity
How do needs interact?
The way different needs combine and the skill, knowledge or coordination needed to manage them safely.
Unpredictability
How difficult are needs to anticipate?
Fluctuation, sudden change and the consequences of an inadequate or delayed response.
What does not decide CHC eligibility?
Savings or property. CHC is not means-tested.
A diagnosis by itself. Dementia, Parkinson’s disease, stroke or another condition does not automatically qualify or disqualify someone.
The care setting. CHC can be provided outside hospital, including at home or in a care home.
Whether the person is already self-funding. The funding position does not determine the underlying eligibility test.
For dementia specifically, see how cognition, behaviour and interacting risks can affect a CHC assessment.
How is eligibility decided?
01
Initial screening with the CHC Checklist
The NHS CHC Checklist is a screening tool. A positive screen normally leads to a full assessment; it is not itself an award of funding.
02
Full multidisciplinary assessment
A multidisciplinary team considers the evidence and completes the Decision Support Tool and its 12 care domains.
03
Primary health need recommendation
The team considers the totality of needs using the four characteristics and makes a recommendation to the Integrated Care Board.
04
Written decision and reasons
If the decision is negative, the person or representative can examine the reasons and, where appropriate, use the CHC appeal process.
Do well-managed needs still count?
Yes. A need should not simply disappear from the analysis because medication, equipment, supervision or skilled care is successfully managing it. The useful question is what need exists and what intervention is required to keep it controlled. See our detailed guide to well-managed needs in NHS Continuing Healthcare.
What if the person is deteriorating rapidly?
Where a person has a rapidly deteriorating condition and may be entering a terminal phase, the usual route may not be appropriate. An appropriate clinician can consider the Fast Track Pathway so an urgent package can be put in place.
Keep going
The CHC eligibility cluster
Primary health need testThe central legal test and the four characteristics.NHS CHC ChecklistThe first screening stage and what a negative result means.Decision Support ToolThe 12 domains, scoring and professional judgement.Dementia and CHCHow cognition, behaviour and risk can interact.FNC versus CHCWhy funded nursing care is different from full CHC.Appealing a refusalWhat to do when the evidence and decision do not align.CHC evidence & numbers 2026
Official rates, timings and national data →
Official rates, timings and national data →