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Long-Term Care

NHS Continuing Healthcare letter explained

📖 6 min readNHS.uk sourcedUpdated April 2026
In plain English

NHS Continuing Healthcare (CHC) is fully funded NHS care for people with complex long-term health needs. A CHC letter either tells you that you have been assessed as eligible — meaning the NHS will pay for your care — or that you have been found ineligible, which means you may need to fund care yourself.

What is NHS Continuing Healthcare?

NHS Continuing Healthcare (CHC) is a package of care arranged and fully funded by the NHS for adults outside hospital who have ongoing, complex health needs. It covers care home fees, home care, and nursing — with no means testing. If you qualify, you pay nothing.

What triggers an assessment

A CHC assessment is usually triggered when someone is being discharged from hospital and has complex health needs, or when a community health professional identifies that someone's needs may meet the threshold. The assessment uses a tool called the Decision Support Tool (DST).

If you are found eligible

Your Integrated Care Board (ICB) takes responsibility for commissioning your care. You or your family should be involved in decisions about where and how care is provided. You may be entitled to a Personal Health Budget, which gives you more control over how your care is arranged.

If you are found ineligible

You have the right to request a review of the decision. If the review upholds the refusal, you can refer your case to NHS England for an Independent Review. Many families successfully challenge initial refusals — the CHC Alliance and NHS continuing healthcare charities provide free guidance. You should also check whether NHS-funded Nursing Care (FNC) applies, which provides a contribution to nursing home costs even if full CHC does not apply.

Find the relevant Trust or ICB for your area in our NHS Trusts directory.

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NHS.uk sourced · No medical advice given · Free to start

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