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Later-life care

NHS Continuing Healthcare Funding Explained

NHS continuing healthcare is care that the NHS arranges and funds in full for adults with a primary health need. Unlike social care, it is not means-tested.

9 min read · Written by the Fairchild Oldfield team · Last reviewed: July 2026

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Where someone is assessed as eligible for NHS continuing healthcare, the NHS meets the full cost of their care, and no financial means test applies to that funding.
Source: nhs.uk, as at July 2026, subject to change.

NHS continuing healthcare is a package of ongoing care that is arranged and funded solely by the NHS for an adult whose main, or primary, need is a health need. Where someone qualifies, the NHS pays for all of that care, wherever it is delivered, and the funding is not means-tested (nhs.uk, as at July 2026, subject to change).

This matters a great deal for families weighing later-life care costs, because ordinary social care from a local authority is means-tested and can consume savings and, in some cases, the value of a home. This guide explains what NHS continuing healthcare covers, the primary health need test, how the assessment works, and how it sits alongside the local-authority the care means test. It forms part of our wider estate planning guide. Figures are current as at July 2026 and are subject to change.

What is NHS continuing healthcare?

NHS continuing healthcare, sometimes shortened to CHC, is care arranged and funded entirely by the NHS for an adult assessed as having a primary health need. It can be provided in a person's own home, in a care home or a nursing home, and eligibility does not depend on any particular diagnosis or condition, nor on who delivers the care or where (nhs.uk, NHS continuing healthcare, as at July 2026, subject to change). Because the NHS meets the cost in full, no financial means test applies.

Who is eligible for NHS continuing healthcare?

Eligibility turns on whether someone has a primary health need, rather than on a diagnosis. Assessors look at the nature, intensity, complexity and unpredictability of a person's needs across a set of care areas. Someone with at least one priority-level need, or severe needs in at least two areas, can usually expect to be found eligible (nhs.uk, as at July 2026, subject to change).

The full assessment weighs needs across twelve care domains, using a national tool so that decisions are made consistently. A single high need is rarely decisive on its own; it is the overall picture that counts (gov.uk, national framework for NHS continuing healthcare, as at July 2026, subject to change).

Care domain assessedExamples of what is considered
BreathingSupport with breathing, oxygen or ventilation
NutritionHelp with eating, drinking or feeding tubes
ContinenceBladder and bowel management
Skin and tissue viabilityWounds, pressure damage and skin care
MobilityMoving, transfers and falls risk
Cognition, behaviour and psychological needsMemory, mood, and challenging behaviour

Table shows selected domains for illustration; the full assessment covers twelve. Source: gov.uk, national framework, as at July 2026, subject to change.

The process

How the assessment works

There are usually two stages. First, a health or social care professional completes an initial checklist to screen whether a full assessment is needed. If the checklist is positive, a multidisciplinary team of at least two professionals from different disciplines carries out a full assessment using the Decision Support Tool, then makes a recommendation on eligibility (nhs.uk, as at July 2026, subject to change).

A decision on eligibility for a full assessment should usually be made within 28 days of the checklist or a request for assessment (nhs.uk, as at July 2026, subject to change). Where someone is terminally ill and needs care urgently, a fast-track pathway can put funding in place quickly. The person and their family should be involved throughout, and there is a route to ask for a review if eligibility is refused.

Decision timeframe

28 days

A decision on eligibility for a full NHS continuing healthcare assessment should usually be made within 28 days of the initial checklist or a request for assessment (nhs.uk, as at July 2026, subject to change).

NHS continuing healthcare compared with means-tested social care

The two systems are funded very differently, which is why the assessment result carries such weight for families. NHS continuing healthcare is free and not means-tested, while local-authority social care is means-tested against a person's capital. In England, someone with capital above the upper limit of £23,250 generally pays for their own care, and below the lower limit of £14,250 their capital is not counted, with a tariff between the two (gov.uk, social care charging 2026 to 2027, as at July 2026, subject to change).

FeatureNHS continuing healthcareLocal-authority social care
Who funds itThe NHS, in fullYou and the council, depending on the means test
Means-tested?NoYes, against capital
Basis of the testPrimary health needCare needs plus a financial assessment
Capital thresholds (England)Not applicableUpper £23,250, lower £14,250

Capital limits for 2026 to 2027: gov.uk, as at July 2026, subject to change. NHS continuing healthcare funding: nhs.uk. See our guide to Care Home Fees.

A worked example (illustration only). A man with advanced needs following a stroke has capital of £120,000, mostly from savings. If his care is treated as means-tested social care, his capital sits above the upper limit of £23,250, so he would generally pay for his own care until his capital fell towards the lower limit of £14,250 (gov.uk, as at July 2026, subject to change). If instead he is assessed as eligible for NHS continuing healthcare, the NHS meets the full cost and his capital is not touched for that care (nhs.uk, as at July 2026, subject to change). Every case turns on its own assessment, so this is general information rather than a prediction for any real person.

Where CHC does not apply: NHS-funded nursing care

Someone can be assessed as not eligible for full NHS continuing healthcare but still need care from a registered nurse in a nursing home. In that case the NHS may pay a contribution called NHS-funded nursing care, currently a standard flat rate of £267.68 per week from 1 April 2026, paid to the home towards the nursing element of the fees (nhs.uk, NHS-funded nursing care, as at July 2026, subject to change). This is far narrower than continuing healthcare, which covers the whole cost.

Following the pathway

From checklist to decision

I

Checklist

A professional screens whether a full assessment is needed.

II

Full assessment

A multidisciplinary team completes the Decision Support Tool across the care domains.

III

Recommendation

The team recommends whether the person has a primary health need. Source: nhs.uk, as at July 2026, subject to change.

IV

Decision and review

A decision usually follows within 28 days, with a route to seek a review. Source: nhs.uk, as at July 2026, subject to change.

Why NHS continuing healthcare matters for estate planning

For many families the biggest threat to what they hope to pass on is the cost of later-life care, not inheritance tax. Because NHS continuing healthcare is not means-tested while social care is, the assessment result can determine whether savings and a home are drawn on at all. Many people choose to make sure a care needs assessment and any continuing healthcare checklist actually happen, and to understand the difference before decisions are made.

It is worth being clear about the limits of planning here. Deliberately giving away assets to reduce what you pay towards care can be treated by a local authority as a deliberate deprivation of assets, and the value may still be counted in the means test, so this is not a way to avoid care fees (gov.uk, social care charging 2026 to 2027, as at July 2026, subject to change). Sensible care fees planning is about understanding the rules and the assessment routes, and mitigating the impact of care fees within them, rather than trying to sidestep a lawful charge. Because the issues overlap with tax, property and benefits, it can be worth discussing with a qualified professional. To start, see how a care needs assessment works.

NHS continuing healthcare in Scotland and Northern Ireland

This guide describes the position in England, and the other UK nations differ. Scotland does not operate NHS continuing healthcare in the same way; it has its own system, including free personal and nursing care for those assessed as needing it, run through local partnerships. Northern Ireland arranges continuing healthcare through its health and social care trusts under separate guidance. The care means test and its capital limits also vary between the nations, so where care touches more than one UK nation it can be worth taking advice locally.

Frequently asked questions

Is NHS continuing healthcare means-tested?

No. NHS continuing healthcare is arranged and funded solely by the NHS for adults assessed as having a primary health need, and no financial means test applies to that funding (nhs.uk, as at July 2026, subject to change). This differs from local-authority social care, which is means-tested against a person's capital, so the assessment result can matter a great deal.

Who qualifies for NHS continuing healthcare?

Eligibility depends on having a primary health need, assessed across twelve care domains rather than on any single diagnosis. Someone with at least one priority-level need, or severe needs in two or more areas, can usually expect to be found eligible, though the overall picture is what counts (nhs.uk, as at July 2026, subject to change). Each case is decided on its own facts.

How long does an NHS continuing healthcare decision take?

A decision on eligibility for a full assessment should usually be made within 28 days of the initial checklist or a request for assessment (nhs.uk, as at July 2026, subject to change). Where someone is terminally ill and needs care urgently, a fast-track pathway can put funding in place more quickly. Timing can vary between areas depending on circumstances.

What is the difference between continuing healthcare and funded nursing care?

NHS continuing healthcare covers the whole cost of care for someone with a primary health need. NHS-funded nursing care is narrower: it is a contribution towards the nursing element of a nursing home's fees for someone who needs registered-nurse care but is not eligible for full continuing healthcare, currently a standard flat rate of £267.68 per week from 1 April 2026 (nhs.uk, as at July 2026, subject to change).

Can I give assets away so care is paid by the NHS?

No, and it is worth separating two things. Whether the NHS pays depends on a health assessment, not on your assets, so giving assets away does not affect continuing healthcare eligibility. For means-tested social care, deliberately giving assets away to reduce care charges can be treated as deliberate deprivation and the value still counted (gov.uk, as at July 2026, subject to change). Many people take advice first.

What happens if I disagree with the eligibility decision?

You can ask for the decision to be reconsidered. If you disagree with how the assessment was carried out or with the outcome, there is a route to request a review through the relevant NHS body, and further steps beyond that (nhs.uk, as at July 2026, subject to change). Because reviews turn on the detailed evidence, it can be worth getting help from a suitably qualified adviser or advocate.

About Fairchild Oldfield

The Fairchild Oldfield team brings together estate planning, tax, independent financial advice and client care, working with families across England and Wales.

Fairchild Oldfield are estate planning specialists and will writers, not a firm of solicitors. This article is general information based on practical experience, not legal, tax or financial advice.

Important: This article is general information only and is not legal, tax or financial advice. Reading it does not create a professional relationship. It is based on the position in England, and other UK nations may differ. Figures and rules are current as at July 2026 and are subject to change. Before acting, many people choose to seek advice from a suitably qualified professional, such as a solicitor, a STEP practitioner, an accountant, or an FCA-authorised financial adviser, who can consider your individual circumstances.

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