What is NHS Continuing Health Care (CHC)?
NHS CHC funding is a package of health and social care that is arranged and funded by the NHS for adults who have significant care needs.
The funding can be used to pay for nursing care in a residential home and unlike other funding arrangements for care home residents, this funding is not means tested, it is based on need.
Medical staff can fast track patients who they believe to very ill and in need of urgent help but others must make a formal application for this funding .
NHS CHC funding is a complex process underpinned by a formal legal framework. Strict national criteria determine who is eligible for these funds. From the outside, the whole assessment framework can seem impenetrable and many of those who embark on the process are warned that they are unlikely to be successful. The NHS even funds a charity, Beacon, to help people navigate this system.
This article provides a helpful window into the CHC process, its flaws and the variation across the country.
How many people receive CHC funding?
The data for 31March 2024 relates to 52,096 people – 35% fast track and the remaining 65% standard track.
How successful are applications for standard CHC funding?
During the period 1 Jan 24 -31st Mar 24 just over one fifth (21%) who were assessed for standard CHC were found eligible. This is a decrease from 27% in 2017.
Regional Variation in CHC Funding Success Rates
There is significant variation in success rates across the country, ranging from 7.3% in Gloucestershire to 42.5% in Leicester, Leicestershire, and Rutland.
How long does the CHC funding process take ?
The recommended upper limit for a decision is 28 days but delays are common. As of 31 March 2024, 1,730 referrals were incomplete and had been delayed by more than 28 days. 35% of these had been delayed by an additional two weeks, and 2% had been delayed by over 26 weeks.
This is an enduring problem. A previous NAO inquiry in 2017 found almost one third of decisions took longer than the recommended 28 days causing additional distress to those involved and extending hospital stays unnecessarily for some.
Much worse, in 2014, an inquiry led by Parkinson’s UK found patients were dying whilst awaiting funding decisions.
What’s missing?
There is no data about the number of people who apply for NHS CHC funding – it is limited to those who proceed past the checklist stage to the full assessment.
How does the CHC funding process reflect evolving needs?
It doesn’t. The 2014 inquiry noted that needs evolve with progressive conditions, and almost one quarter (24%) of those with Parkinson’s who applied for CHC had to be continuously reassessed.
Is there any point in appealing?
There is a three stage appeal process starting at a local level. Most recent data indicate that around one in six eligibility decisions are being overturned following challenge at a local level.
How easy is the CHC funding process ?
The Parkinsons’ UK Inquiry found that 40% of people going through the assessment process reported a lack of empathy and transparency from professionals.