NHS continuing healthcare at home: who qualifies in 2026

Key Takeaways

NHS continuing healthcare is free NHS funding for adults with a "primary health need". It can pay for a care package in your own home, with no means test on savings.

It is not automatic, and the standard route is slow. Ask for the checklist. Arrange cover while you wait, because the household still needs someone at 7.30am.

What is NHS continuing healthcare?

NHS continuing healthcare is a package of care arranged and funded solely by the NHS for adults assessed as having a primary health need. The NHS is plain: it can be provided outside hospital, in your own home or in a care home.

Eligibility depends on assessed needs, not on a particular diagnosis, and not on how much is in the bank. If the needs change, eligibility can change with them.

Your local integrated care board (ICB) commissions it. Age UK's February 2026 guide puts the test in ordinary language: ongoing, significant physical or mental health needs, where the main part of the care is about addressing or preventing those health needs.

This piece is the England process. Wales has a similar scheme. Scotland uses Hospital Based Complex Clinical Care, which is a different beast and is not a home-care cheque.

I get asked about CHC in the same week as hourly visiting rates and council assessments. CHC is the route with no capital limit, and the one families hear about last.

How the checklist and Decision Support Tool work

Most people start with the NHS Continuing Healthcare Checklist. A nurse, doctor, other clinician, or social worker can complete it. You should be told it is happening, and you should get a signed copy.

A positive checklist only opens the full assessment.

That full assessment uses the Decision Support Tool. A multidisciplinary team, at least two professionals from different disciplines, usually including health and social care people already involved, scores twelve domains: breathing, nutrition, continence, skin, mobility, communication, psychological and emotional needs, cognition, behaviour, medication, altered states of consciousness, and anything else significant.

Each domain is weighted: priority, severe, high, moderate, low, or no needs. The NHS says that one priority, or two severes, usually means you can expect eligibility. You can also qualify on a mix of high and moderate needs if the nature, intensity, complexity, or unpredictability of the whole picture adds up to a primary health need.

Bring a diary. Who gets up in the night. How long a transfer actually takes. What happens on a bad day, not the Tuesday the assessor visits. Beacon, which the NHS names for free independent advice, is blunt that unpaid family care can hide the real level of need. If you vanished tomorrow, what would a paid carer have to do?

The ICB should usually decide within 28 days of a completed checklist or a request for a full assessment. If they then say yes, and the delay past 28 days was unjustifiable, they should refund care costs from day 29.

Fast Track continuing healthcare

If health is deteriorating quickly and the person may be entering a terminal phase, skip the checklist. A clinician completes the Fast Track Pathway Tool. That document itself can establish eligibility. Care should be put in place as soon as possible, usually within 48 hours.

A son in Peckham had this after a district nurse visit on a Thursday. His father was already at home. Nobody was talking about a ward. By Saturday there was a waking-night carer and two daytime visits. Fast Track is reviewed. If the condition stabilises, the ICB can reassess, and the money can stop.

If you are in that territory, our palliative care guide is the wider picture. CHC is the funding route, not the clinical plan. A GP or specialist nurse decides whether Fast Track fits. I will not.

What NHS continuing healthcare pays for at home

If you are eligible at home, the NHS pays for the package that meets assessed health and associated social-care needs. That includes personal care: washing, dressing, the toilet, transfers, medication prompts. It does not pick up the council tax or the Tesco shop.

You have had a legal right to a personal health budget since October 2014. NHS England expects most CHC packages in a person's own home to run as one, unless there is a good reason not to. A personal health budget can be notional, a third-party arrangement, or a direct payment for healthcare. It cannot be used to pay care-home fees.

You cannot "top up" a CHC package the way some families top up council care. Extra private services have to sit separately, with different staff, preferably in a different setting.

The ICB still has to consider cost and value for money. Preferring to stay at home is relevant. They will still price the hours.

A daughter in West Ealing has been paying for live-in care privately since May while the Decision Support Tool for her mother's Parkinson's sits with the ICB. Same carer, same spare room, invoices in a folder labelled "CHC wait". I do not know what the ICB will say. The Parkinson's nurse does not know either.

How often is NHS continuing healthcare awarded?

I have been sitting on this figure because it sounds like a reason not to ask.

At the end of June 2026, NHS England counted 52,141 people in England eligible for CHC: 33,972 on the standard route and 18,169 on Fast Track. In April to June 2026 the standard assessment conversion rate was 18 per cent. That is 2,295 people found eligible out of 13,001 standard assessments. Roughly one in six.

Fast Track is a different funnel. Almost every Fast Track assessment in that quarter was recorded as eligible. About 95 per cent of Fast Track referrals converted.

Of standard referrals completed in the same quarter, 67 per cent finished within 28 days.

ADASS's Spring Survey 2026, published in July, is the mood music around those numbers. 58 per cent of directors of adult social care said their integrated care board had dis-invested in CHC. 71 per cent said more people were being reviewed and found ineligible. Three-quarters reported more people arriving at the council who were, or would previously have been, CHC-eligible.

Keep the invoices. The letter, when it comes, will not rewind last Tuesday.

Who pays while you wait

CHC does not freeze council duties or private invoices.

Request a free care needs assessment from the council where the person lives. Savings do not block that assessment. In England, capital over £23,250 usually means you pay the social-care cost if the council later agrees there is a need. The home you live in is normally left out of that test for care at home. Paying for home care covers the means test and direct payments.

Attendance Allowance is separate and not means-tested. Claim it on care needs, not on whether the ICB has finished.

If you start private visiting care in the meantime, keep the invoices distinct. If CHC is later awarded and the 28-day clock was missed without good reason, those receipts are how you ask for a refund.

If the ICB says no

The decision letter should say how to challenge it. First the ICB reconsiders. Then you can ask for an independent review. The NHS also points people to Beacon on 0345 548 0300.

A refusal can still leave other NHS money on the table in some settings. If someone needs nursing in a care home, NHS-funded nursing care may still apply. From 1 April 2026 the standard rate is £267.68 a week, paid to the home. That weekly sum stays with the home. It does not follow you into a kitchen in Ealing.

There is also a joint package, where the NHS pays for some health elements and the council (or you) pays for the social-care rest. Get that split in writing.

If you should have been assessed in the past and were not, look up a previously unassessed period of care. That is a retrospective request, usually only for periods after April 2012.

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How Match with Care can help

CHC decides who funds the hours. It does not produce a named person at 8am on Monday, and it does not fill the weeks before the DST meeting.

Match with Care is a managed introductory care marketplace. We interview carers, check enhanced DBS, right to work, and references, then show you profiles so you can meet someone before they have a key. We are not a traditional domiciliary care agency, and we are not CQC-registered as a care provider. Introductory matching does not work that way.

What we can do during a CHC wait, or alongside a personal health budget later, is introduce a vetted carer for the slots you actually need, often the same person each weekday, with a care advisor if the match is wrong. Visiting matches often come in around 20 to 30 per cent below typical agency quotes. Hours go in the app. You get a weekly invoice you can keep next to the ICB paperwork.

If you want to talk through hours before the eligibility letter arrives, call +44 7962 657635 or email hello@matchwithcare.com.

Some families get the letter. Some get the review that takes the funding away six months later. Both of those are happening in the same month, in the same city. I cannot tell you which one you are in.