At the moment, our information about paying for care services applies to England only. We are updating our information to make it relevant for people living in Scotland and Wales. In the meantime, please visit Age Scotland or Age Cymru.
If you have complex health and care needs, the NHS might need to pay for your care outside hospital. This could be in your home or in a care home.
What is NHS Continuing Healthcare?
NHS Continuing Healthcare is care that's arranged and paid for by the NHS. It covers personal care, health care, and care home fees including food and accommodation.
If you qualify, your care will be free. The NHS will not look at your finances to see if you need to pay towards the costs.
Who can get it?
To get NHS Continuing Healthcare, you must have an assessment by health and care professionals. People who can get it:
- have significant (very high) health and care needs – your main need for care must be health-related. The professionals will say that you have a ‘primary health need’
- need ongoing care outside of hospital.
There’s no list of conditions that mean you’ll automatically get NHS Continuing Healthcare – the assessment looks at your personal situation.
When can you have an assessment for NHS Continuing Healthcare?
An assessment might happen when:
- you're about to be discharged from hospital, for example
- your care needs are being looked at as part of a care needs assessment
- your needs are reviewed while you’re in a nursing home.
If you’re not given an assessment, but think you should have been, ask your GP, doctor, social worker. You can also ask your local Clinical Commissioning Group (CCG) – they are responsible for health services in your area. Find the contact details on your local CCG on the NHS website.
How you'll be assessed
The first step is usually a screening assessment using the Checklist Tool. Your health or care professionals use this document to decide if you qualify for a full assessment.
In the full assessment, they use the Decision Support Tool (DST). This tool is to work out whether you have a ‘primary health need’ – if you do, you can get NHS Continuing Healthcare.
When you have an assessment, health and care professionals will look at:
- the nature of your health and care needs – what your needs are like and how they affect your overall health and wellbeing
- How intense your needs are – how many different health needs you have, how severe they are and how long you’ve had these needs
- How complex your needs are – if your needs are difficult to manage, or you need specialist care and treatment
- How unpredictable your needs are – how much and how often your needs change.
If you get NHS Continuing Healthcare, your health and care needs will be reviewed three months after you first qualify, and at least once a year after that, to make sure you’re still getting the right care. If your condition changes, you may find you no longer qualify for NHS Continuing Healthcare. This can only happen if:
- you have another full assessment and a new DST is completed
- the DST shows that you no longer have a primary health need.
If you’re turned down for NHS Continuing Healthcare after a full assessment, you have the right to ask for the decision to be reviewed. Read our factsheet Continuing Healthcare – should the NHS be paying for your care? for more information, or call our Helpline on 0800 319 6789 to speak to an adviser.
NHS-funded nursing care
If you can’t get NHS Continuing Healthcare, you may qualify for NHS-funded nursing care. You can get this if:
- you’re assessed as needing nursing care and
- you’re living in a nursing home.
If you’ve had a full NHS Continuing Healthcare assessment, this should provide enough information to decide if you can get NHS-funded nursing care.
If you qualify, you’ll get £209.19 a week (2022/23 rate) towards the nursing part of your care home fees. If you pay your own fees, this money is normally paid directly to the nursing home. This could reduce your overall care home fee (depending on your contract with the home). If the council pays for your care, the funding will go straight to them.
Also of interest
Also in this section
For more information on who can get NHS Continuing Healthcare and how the assessment works, visit the NHS website, read our factsheet Continuing Healthcare - should the NHS be paying for your care? or call our Helpline on 0800 319 6789 to speak to an adviser.
If you want to ask for an assessment, contact your CCG’s NHS Continuing Healthcare team. Find their details by entering your GP surgery’s postcode on the NHS website.
Call our free Helpline on 0800 319 6789
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