NHS continuing healthcare (NHS CHC)

What is NHS CHC?

NHS CHC is a package of care arranged and funded solely by the NHS to meet physical and/or mental health needs that have arisen because of disability, accident or illness. It can be provided in any setting including, but not limited to, a care home, a hospice or your own home.

Eligibility is decided via a full assessment where the ‘nature’, ‘intensity’, ‘complexity’ or ‘unpredictability’ of someone’s health needs mean that they have to be actively managed by the NHS. Eligibility decisions for NHS CHC rest on whether your need for care is primarily due to your health needs – often referred to as having a ‘primary health need’ (as opposed to a need for care due primarily to social care needs that fall within the remit of social services departments, rather than the health service). The quality and/or quantity of care required to meet an individual’s needs may demonstrate a ‘primary health need’.

Examples of scenarios where it may be appropriate to consider potential eligibility for NHS CHC

• When someone is ready to be discharged from hospital and their long term needs in regard to ongoing care and support are clear to the health and social care practitioners who have been working with them (also see our page on hospital discharge arrangements for further information).
• Once a period of intermediate care, rehabilitation or other NHS funded service – offered at the end of a period of acute hospital treatment – has finished and it is agreed no further improvement in your condition can be expected.
• When someone’s social care and support needs are being reviewed via a care needs assessment by the local authority social services department.
• If your physical or mental health deteriorates significantly and your current level of care – at home or in a care home – seems inadequate.
• When, as a resident of a nursing home, your nursing care needs are being reviewed.
• If you have a rapidly deteriorating condition with an increasing level of dependency and may be approaching the end of your life (in this case you may be eligible for your CHC care services to be set up via a ‘fast track’ route).

Who should you contact in the above scenarios if NHS CHC has not been discussed with you?

In circumstances such as those outlined above, you can raise the issue of NHS CHC and the possibility of organising an assessment to see if you are eligible with:

• Hospital staff directly involved with your care (in particular, discharge staff);
• Staff co-ordinating your intermediate care;
• Social services;
• Your GP.

We have a detailed factsheet on NHS continuing healthcare (NHS CHC) in Wales, which can be accessed below. This covers topics including:

• the process for deciding whether someone is eligible to receive it;
• how the services will be delivered for those who are eligible; and
• what to do if you are unhappy with the decision reached.

Factsheet 20w: NHS continuing healthcare and NHS-funded nursing care in Wales