Eligibility for continuing healthcare

Who is eligible for continuing healthcare?

Eligibility does not depend on a particular disease, condition or diagnosis, where the care is provided or by whom. If an assessment determines that you have a primary health need, you may be eligible. 

You need to be 18 years or over and be assessed as having a certain level of care need to be entitled to NHS continuing healthcare. Assessments for eligibility will be made in accordance with the Department of Health National Framework.

You can find out more about the CHC process here.

Children and young people (aged under 18) with complex health needs may be eligible for NHS continuing care funding. You can find more information of children continuing healthcare by clicking here.

What happens if I am not eligible for fully funded NHS continuing healthcare?

Funded nursing care

In cases where individuals are in a nursing home and it has been deemed that they do not meet the eligibility criteria for continuing healthcare funding, they may well be eligible for NHS funded nursing care. This is because the nursing fee includes an additional cost for the employment of Registered Nurses. The decision as to whether you are eligible for funded nursing care will be given to you at the same time that a decision is made regarding your eligibility of fully funded NHS continuing healthcare. The public information leaflet explains this in more detail.

Other health and social care services

If you have a medical need for then, please be assured that you will continue to receive health support through universal health services such as your GP or community health staff. In addition, if you have social needs you might be able to apply for help from the local authority Department of Health and Social Care.

The following directory of services might also help to signpost you to services that could assist you further.