NHS-funded care: Continuing Healthcare and Funded Nursing Care

Two different things, one confusing name

NHS Continuing Healthcare (CHC) pays for everything — accommodation, meals, personal care, nursing. Whatever your savings. Whatever you own.

NHS-funded Nursing Care (FNC) pays £267.68 a week towards the nursing element only, directly to the home. Also not means-tested, but a fraction of the bill.

Eligibility has halved, and the criteria have not changed

King’s Fund research published in June 2026 found that the proportion of applicants for standard CHC assessed as eligible was 31.25% in April–June 2017 and 16.65% in January–March 2026. From nearly one in three to fewer than one in five.

Over the same period the number of Fast Track recipients found no longer eligible on reassessment rose by 28.21% — despite no change to the criteria.

Nuffield Trust found the number of standard assessments completed per quarter fell from 16.5 to 12.6 per 50,000 people between mid-2017 and March 2024: 24% fewer people assessed at all.

Where you live decides more than it should

In the same quarter, January to March 2026, 35.37% of people assessed for standard CHC in the Cambridge and Peterborough ICB were found eligible. In Gloucestershire the figure was 2.26%.

A fifteen-fold difference under one national framework. The King’s Fund has called for a review into the variation.

The question: health need or social care need?

CHC is not awarded for a diagnosis. It is awarded where someone has a primary health need. Two people with identical dementia diagnoses get opposite decisions, and often do.

Assessors work through twelve care domains and weigh four characteristics. Learn these four words, because they are the vocabulary of the decision:

• Nature — what kind of needs are these, and what effect do they have?
• Intensity — how severe, and how much support do they require?
• Complexity — how difficult are they to manage, and do they interact?
• Unpredictability — how much do they fluctuate, and what is the risk if a skilled response is not immediately available?

A need that is intense but stable and manageable points away from CHC. A need that is unpredictable, requires skilled judgement in the moment, and carries real risk if that judgement is absent points towards it.

The process, and where it goes wrong

1. Checklist — a short screening. Anyone can ask: a nurse, a social worker, a GP, the family. Deliberately low-threshold.
2. Decision Support Tool — a full multidisciplinary assessment across the twelve domains.
3. Recommendation to the Integrated Care Board, which decides.

Where it goes wrong: nobody mentions the Checklist. Families are told a home costs £1,200 a week and never told a different funding route exists. Ask for the Checklist explicitly, by name, and ask for any refusal in writing.

If you are turned down, appeal

Nuffield Trust found that in one quarter of 2023/24 there were 596 local resolution requests, of which 13% resulted in eligibility — roughly one in six decisions overturned at the first stage.

Local resolution with the Integrated Care Board that made the decision. Ask for the completed Decision Support Tool and read what was recorded against each domain; decisions are frequently overturned because a domain was scored below what the evidence supports.

Independent review by NHS England if local resolution fails.

Both are free. Neither requires a solicitor, though CHC claims are a substantial industry and you will be marketed to.

Funded Nursing Care

If CHC is refused but nursing care is needed, FNC applies: £267.68 a week from 1 April 2026, paid by the NHS to the home.

It only applies in a home registered for nursing. Watch the accounting: some councils publish nursing rates including FNC and some excluding it, so the same home can appear to cost £880 or £1,148 depending on who is describing it. See nursing homes.