The Family Guide to NHS Continuing Healthcare Funding

Understand the CHC process. Gather the right evidence. Feel more prepared.

If someone you love needs care, the question of who pays can quickly become confusing, stressful and overwhelming.

NHS Continuing Healthcare (CHC) funding can cover the full cost of care for people whose assessed needs are primarily health needs. But many families only hear about it when they are already exhausted, facing care home fees, hospital discharge decisions, complex paperwork or meetings they do not fully understand.

This guide was written for families and carers who want clear, practical help before, during or after the NHS Continuing Healthcare process.

It does not promise an outcome. It is not legal, medical or financial advice. It is a plain-English guide shaped by real family experience, practical lessons and careful use of official guidance, designed to help you understand what matters and prepare more confidently.

Written by people who have been through NHS CHC funding process

The Family Guide to NHS Continuing Healthcare Funding was created because we know how confusing the CHC process can feel when you are trying to support someone you love.

We have been through the stress of care decisions, funding uncertainty, forms, meetings, records and unclear language. We also know how easy it is to realise too late that you should have asked for evidence earlier, written things down differently, or asked more questions at the right stage.

This site, the free NHS Continuing Healthcare checklist and the full guide have grown from that experience.

They are designed to help families and carers feel more prepared, more organised and less alone. We cannot promise an outcome, and we do not provide legal, medical, financial, advocacy or appeals services. What we can offer is calm, practical, plain-English guidance to help you understand the process, gather useful information and approach conversations with more confidence.

What this CHC guide helps you do

This guide helps you:

• understand what NHS Continuing Healthcare funding is and who may need to be considered
• understand why eligibility is about care needs, not diagnosis alone
• prepare before a Checklist or full assessment
• understand the 12 care domains used in the Decision Support Tool
• recognise how needs may interact across areas such as cognition, behaviour, mobility, nutrition, medication and communication
• gather and organise useful evidence
• keep a clear care diary
• prepare questions for meetings
• understand how to read an outcome
• think more clearly about what to do if you disagree with a decision

What is inside the guide?

This 84-page digital guide is a practical resource for families and carers who want a clearer, calmer way to understand NHS Continuing Healthcare funding.

It brings together plain-English explanations, practical preparation steps, condition-specific guidance, worked examples, domain cheat sheets, templates, sample letters and a quick evidence summary. You can read it from start to finish, or use it as a reference when a Checklist, full assessment, Decision Support Tool outcome or challenge is in front of you.

Front matter and first steps

• Copyright and publication note
• Important disclaimer
• Independence statement
• Privacy note
• Introduction: Read this first

Part One: Understanding NHS Continuing Healthcare

1. What NHS Continuing Healthcare is
2. Who may qualify
3. The Primary Health Need test
4. The process from first request to final decision
5. Consent, capacity and family involvement

Part Two: The Checklist and the Full Assessment

6. How to start the process
7. The CHC Checklist explained
8. When people are discouraged from applying
9. The Decision Support Tool explained
10. The four key characteristics: nature, intensity, complexity and unpredictability

Part Three: The 12 Care Domains

11. Breathing
12. Nutrition – food and drink
13. Continence
14. Skin and tissue viability
15. Mobility
16. Communication
17. Psychological and emotional needs
18. Cognition
19. Behaviour
20. Drug therapies and medication
21. Altered states of consciousness
22. Other significant care needs

Part Four: Building the Evidence File

23. Evidence is everything
24. How to keep a care diary
25. How to prepare for the MDT meeting
26. How to read a DST outcome
27. Appeals and challenges
28. When professional help may be worth considering
29. The 30-day action plan, including what to do across days 1 to 30

Part Five: Condition-specific guidance and worked examples

This expanded section helps families connect the CHC process to real care situations without making assumptions based on diagnosis alone.

30. What conditions qualify for continuing healthcare?
31. Dementia and NHS Continuing Healthcare
32. Parkinson’s disease, Lewy body dementia and fluctuating needs
33. Diabetes, insulin and medication monitoring
34. Stroke, brain injury and physical disability
35. Frailty, falls and care home fees
36. Fast Track CHC and end-of-life situations
37. Worked example: dementia, diabetes and distress
38. Worked example: refused at Checklist
39. Worked example: challenging a DST score
40. Worked example: when managed needs still matter
41. Writing your own domain submission
42. How to avoid overclaiming
43. How to use this guide with our other resources

Part Six: Domain cheat sheets for families

The domain cheat sheets are designed for quick reference when you are reviewing records, preparing notes or trying to explain needs clearly.

44. How to use the domain cheat sheets
45. Breathing cheat sheet
46. Nutrition cheat sheet
47. Continence cheat sheet
48. Skin cheat sheet
49. Mobility cheat sheet
50. Communication cheat sheet
51. Psychological and emotional needs cheat sheet
52. Cognition cheat sheet
53. Behaviour cheat sheet
54. Drug therapies and medication cheat sheet
55. Altered states of consciousness cheat sheet
56. Other significant care needs cheat sheet

Appendices and practical tools

• Glossary
• Evidence checklist
• Daily care diary template
• Incident and behaviour log template
• Medication and symptom tracker
• Questions to ask before and during the assessment
• Sample letter requesting a CHC Checklist
• Sample letter requesting records
• Sample letter challenging an outcome
• Sources and further reading
• Quick domain evidence summary

Who this guide is for

This guide is for you if:

• your parent, partner or relative needs significant care
• you are worried about care home fees or long-term care costs
• someone has mentioned NHS Continuing Healthcare but not explained it clearly
• a Checklist or assessment is being arranged
• you are unsure what evidence matters
• you feel that the person’s needs are being understated
• you want to prepare calmly before a meeting
• you want to understand the process before deciding whether professional help is needed

It may be especially useful where care needs involve dementia, Parkinson’s disease, stroke, frailty, diabetes, severe mental health symptoms, mobility problems, falls, distress, communication difficulties, medication monitoring or several needs interacting at once.

What makes it different

This is not a dense professional textbook.

It is a family guide.

It has been written to help you understand what is happening, what questions to ask, what to write down and what evidence may be useful. It explains the process without assuming you already understand NHS language.

The aim is not to overwhelm you with every technical detail. The aim is to help you feel more organised, more informed and less alone.

Why preparation matters

Families often know far more about the person’s day-to-day needs than the paperwork shows.

You may know how often your relative refuses food, becomes distressed, falls, forgets to drink, cannot explain pain, resists care, wakes at night, needs supervision or becomes unsafe.

But if those needs are not recorded clearly, they can be missed or understated.

This guide helps you turn what you know into organised, practical information that can be used to ask better questions and prepare for conversations about care and funding.

Digital delivery

This product is supplied as an instant digital download. There is no physical product and no postage or shipping.

Because this is a digital product, purchases are intended to be final once access or download has started, except where required by law.

Important: what this guide does not do

This guide:

• does not guarantee NHS Continuing Healthcare funding
• does not assess eligibility
• does not replace official NHS or GOV.UK guidance
• does not provide legal, medical, financial, consultancy, advocacy or professional advice
• does not act as representation in appeals or disputes, and does not include telephone support
• is not produced by, endorsed by or affiliated with the NHS, NHS England, any Integrated Care Board, local authority, care provider or consultancy

It is an independent educational resource for families and carers.

Frequently asked questions

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