Continuing healthcare (CHC) is a package of care that is arranged and funded by the NHS.

It may be provided to an individual aged 18 or over to meet their needs following disability, accident or illness. Care may be given in an individual’s own home, residential or nursing home, or another specialist care setting.

Eligibility depends on an individual’s assessed needs, not on any particular diagnosis or condition, so if your needs change, your eligibility for CHC may also change.

A team of healthcare professionals will assess if an individual has a ‘primary health need’ by looking at all of their care needs including the intensity, complexity and unpredictability.  The individual being assessed will be involved in the process and their views will be taken into account. Where appropriate, carers and/or family members may also be consulted.

Eligibility for CHC and how we work locally is guided by the National Framework for CHC and FNC October 2022 (pdf, 2.2MB)

Who are these services for?

CHC services are for people who, because of a primary health need, are eligible for NHS CHC. This includes all adults 18 and over who may have complex physical disabilities, learning disabilities and/or complex emotional and psychological needs.

CHC eligibility is not determined by a specific diagnosis but by the level and nature of needs arising from that diagnosis. To assess these needs, a comprehensive health needs assessment is carried out by a multidisciplinary team of health and social care professionals, using nationally approved tools set out by the Department of Health.

 For further information please contact the CHC team at bswicb.chcassessreview@nhs.net.

Tools used in a CHC assessment:

Fast-Track Funding

In certain situations, a clinician may decide a person should be fast-tracked for CHC. During the Fast Track process, a person avoids having a full assessment. A person may be eligible to receive fast-track CHC funding if:

  • they have a rapidly deteriorating condition that may be terminal
  • their needs must be met urgently, for example by providing appropriate end-of-life care in their own home or chosen care setting

For further information please contact the CHC team at bswicb.chcdutyft@nhs.net

NHS-funded Nursing Care

If your are not eligible for CHC, but are assessed as requiring nursing care in a care home, your may be eligible for NHS-funded nursing care (pdf, 2.2MB). This means that the NHS will pay a contribution towards the cost of your registered nursing care.

Personal Health Budgets

From April 2014 anyone eligible for CHC wanting to have their care provided outside of a care home setting, will be able to receive the money they need to pay for their services as a Personal Health Budget (PHB), in the form of a Direct Payment.

This will give people a greater choice over how, when and who provides their care and support. A PHB can be discussed in detail with the Nurse Assessor responsible for your assessment.

Integrated Personalised Commissioning

The ICB is committed to the NHS Five Year Forward View, which sets out a vision for the future that includes greater control for patients and communities over their own health and care services.

Key to supporting the visions set out in the Five Year Forward View is the development of Integrated Personalised Commissioning (IPC). IPC is a new approach to joining up health, social care and other services, which builds on lessons learned from personal budgets in social care and PHBs.

Social care teams are working together to develop what will be offered to the local population by way of IPC and PHBs. Updates and further information will soon be published here.

Children's Continuing Care

Children and young people with complex health needs may require ongoing care beyond what is routinely provided by universal or specialist services. Children’s Continuing Care offers tailored packages of care to meet these needs, ensuring support at home, in the community, or in specialist settings.  Eligibility is assessed using the National Framework for Children and Young People’s Continuing Care, which considers physical, psychological, and social needs. Care packages are designed in partnership with families and professionals to promote wellbeing and quality of life.

For more information or to discuss a referral, please contact our Children’s Continuing Care team at bswicb.childrensclinicalteam@nhs.net

You can read the National Framework for Continuing Care England here - National-framework-for-continuing-care-england.pdf

Complex Rehabilitation for Acquired Brain Injury 

Some people with an acquired brain injury may require intensive specialist rehabilitation outside of hospital following their stay. This helps individuals achieve their maximum functional ability.

Where possible, patients leave hospital with support from NHS services, including therapy from the community Acquired Brain Injury Rehabilitation Service. In some cases, the level of therapy and support needed may exceed what community services can provide, and a specialist placement may be required for a period of time to meet rehabilitation goals.

For further information, please contact the CHC team at bswicb.abiteam@nhs.net

Refreshed Redress Guidance

On 1st April 2015, NHS England published the refreshed NHS Continuing Healthcare – Redress Guidance.

This guidance is to be used by the ICB when considering NHS Continuing Healthcare redress payments for individuals. The document has been updated to reflect the ‘Principles for Remedy’ from the Parliamentary and Health Service Ombudsman (PHSO) for all public bodies. The guidance retains the principle of returning the individual to the financial position they would have been in had they been assessed as eligible and the need for redress identified.

ICB Patient Advice and Liaison Service (PALS) and Complaints Service

You can ask for advice, information or talk to us about a concern or complaint. PALS and complaints will work with you to try to resolve a difficulty or problem. We can discuss with you the best ways to resolve your concerns or problems and will agree with you what action to take for your individual circumstances. We can also signpost to other sources of help if needed. Your personal details remain confidential, unless you provide consent for us to share them. Information from PALS and complaints is also used anonymously to help improve services.

If you have received particularly good service from any health service provider or you have any comments or suggestions to make, please let us know. This information will help us to keep improving our services.

For enquiries, compliments concerns, complaints or general feedback you can contact our PALS service.

Appealing a CHC Decision

If you disagree with the outcome of an NHS Continuing Healthcare (CHC) assessment, you have the right to request a review in line with the National Framework for NHS Continuing Healthcare and NHS funded Nursing Care July 2022 (Revised).

Appeal requests must be submitted within 6 months of the date on your decision letter. For guidance on how to appeal, including what information you need to provide, please contact our CHC team at bswicb.chcretroappeal@nhs.net.

CHC Retrospective Claims (Previously Unassessed Periods of Care – PUPoC) 

If someone with complex health needs has paid for their own care without being assessed for NHS Continuing Healthcare (CHC), they may be eligible to reclaim those costs for periods dating back to 1 April 2012.

For guidance on how to apply for a retrospective claim, including what information you need to provide, please contact our CHC team at bswicb.chcretroappeal@nhs.net.

Please find links to further information here:

BSW ICB Children's Continuing Care Policy (pdf, 694KB)

BSW ICB Guidance for supporting educational and community settings to meet the needs of children and young people with medical conditions (docx, 1.41MB)

If you need any further information please contact the CHC team at bswicb.chcassessreview@nhs.net