Some people with long-term, complex health needs qualify for free social care, arranged and funded solely by the NHS. This is known as NHS Continuing Healthcare (CHC). CHC can be provided in a variety of settings outside hospital, such as in your own home or in a care home. CHC covers all of your identified care costs and is not means-tested. This means it is not based on what you earn, or your savings.
Find out more about Children and Young People’s Continuing Care here.
The National Framework for NHS Continuing Healthcare
The NHS CHC process is set out in the National Framework for NHS Continuing Healthcare. The framework is written and produced by the Department of Health and Social Care and was revised in July 2022. It sets out the principles and processes of NHS Continuing Healthcare.
You can find an Easy Read version of the framework here.
We understand that NHS Continuing Healthcare is a complex and highly sensitive area which can affect people at a very vulnerable stage of their lives. We are here to help. If you have any questions or concerns, please do not hesitate to contact our teams using the links below.
The Integrated Care Board (ICB), amongst other functions, fulfils the role previously held by Clinical Commissioning Groups (CCGs) and is responsible for the provision of relevant NHS services, which includes NHS All Age Continuing Care (AACC).
Services are provided in separate teams across the ICB based on the previous geography of the CCGs – Isle of Wight, Portsmouth, Southampton and Hampshire.
Isle of Wight
If you are registered with a GP practice in the Isle of Wight, contact details are as follows:
Phone: 0300 123 4448 Option 1
Email: hiowicb-hsi.aacc.iow.chc@nhs.net
Isle of Wight NHS Continuing Healthcare Service
Building A
The Apex
St Cross Business Park
Monks Brook
Newport
Isle of Wight
PO30 5XW
Southampton
If you are registered with a GP practice in the Southampton, contact details are as follows:
Phone: 0300 123 4448 Option 2
Email: hiowicb-hsi.aacc.soton.chc@nhs.net
NHS Commissioning HQ
Oakley Road
Southampton
SO16 4GX
Portsmouth
If you are registered with a GP practice in Portsmouth, contact details are as follows:
Phone: 0300 123 4448 Option 3
Email: ContinuingCare117@portsmouthcc.gov.uk
Floor 5, Core 5-6
Civic Offices
Guildhall Square
Portsmouth
PO1 2AL
Portsmouth Children’s Complex Care
Email: ChildrensComplexCare@portsmouthcc.gov.uk
Core 5-6
Civic Offices
Guildhall Square
Portsmouth
PO1 2AL
Hampshire
If you are registered with a GP service in Hampshire, contact details are as follows:
Phone: 0300 123 4448 Option 4
Email: hiowicb-hsi.aacc.hants.chc@nhs.net
NHS Continuing Healthcare
5th Floor
Civic Offices
Fareham
Hampshire
PO16 7AZ
Hampshire and Isle of Wight Children's and Young Peoples Continuing Complex Care Team
Phone: 0300 123 4448 Option 5
Email: hiowicb-hsi.aacc.hants.cypcc.complex@nhs.net
NHS Continuing Healthcare
5th Floor
Civic Offices
Fareham
Hampshire
PO16 7AZ
Learning Disabilities & Autism
Email: hiowicb-hsi.aacc.hants.ldchc-s117@nhs.net
Phone: 0300 123 4448, Option 6
NHS Continuing Healthcare
5th Floor
Civic Offices
Fareham
Hampshire
PO16 7AZ
Mental Health & Section 117 & Acquired Brain Injury Rehabilitation
Phone: 0300 123 4448, Option 7
Email: hiowicb-hsi.aacc.Hants.MHS117@nhs.net (Mental Health & Section 117)
Email: hiowicb-hsi.aacc.hants.abi@nhs.net (Acquired Brain Injury Rehabilitation)
Email: hiowicb-hsi.aacc.mca-dolteam@nhs.net (Mental Capacity Act (MCA)and Deprivation of Liberty)
NHS Continuing Healthcare
5th Floor
Civic Offices
Fareham
Hampshire
PO16 7AZ
Individualised Commissioning and brokerage
Phone: 0300 123 4448, Option 8
Email: hiowicb-hsi.aacc.commissioning@nhs.net (Individualised Commissioning)
Email: hiowicb-hsi.aacc.mhldcommissioning@nhs.net (Mental Health Individualised Commissioning)
Email: hiowicb-hsi.AACC-brokerage@nhs.net
NHS Continuing Healthcare
5th Floor
Civic Offices
Fareham
Hampshire
PO16 7AZ
In order to find out it you are eligible for NHS Continuing Healthcare a two stage assessment process is followed:
- Stage 1: Screening via the Checklist tool
- Stage 2: Full assessment of eligibility via a Multi-Disciplinary Team Meeting
In order for the NHS Continuing Healthcare process to begin you or your chosen representative will need to provide written consent, both for the process to take place, and for the sharing of data with the relevant health and social care professionals.
Although the usual NHS Continuing Healthcare assessment would involve a face-to-face Multi-Disciplinary Team meeting, due to COVID-19 some of these meetings are being completed virtually in order to reduce the risk of spreading the virus.
Stage 1: NHS Continuing Healthcare Checklist Screening Tool
To help correctly identify if you require a full assessment of eligibility for NHS Continuing Healthcare, a health or social care professional involved in your care will complete a screening tool called a Checklist.
They may also speak to your family or others who support you to build up a picture of your needs. This checklist is sent to us, the NHS Continuing Healthcare team at the Hampshire and Isle of Wight Integrated Care Board (ICB). You should also receive a copy of the Checklist tool.
Once completed, if the checklist indicates that you require a full assessment of eligibility, we will arrange for a ‘multi-disciplinary team’ meeting to take place.
Stage 2: The Multi-Disciplinary Team Meeting
A ‘multi-disciplinary team’ (MDT) means a team drawn from a number of professional ‘disciplines’ such as doctors, nurses, therapists and social workers. The multi-disciplinary team will be made up of two or more professionals who understand your care needs. They may be from health or social care services.
At the full assessment, CHC staff from Hampshire and Isle of Wight ICB will make sure that you, your chosen representative, as appropriate, and whoever cares for you are invited to be involved. If you need an advocate to support you through the assessment process, Hampshire and Isle of Wight ICB can help arrange this for you.
Members of the multi-disciplinary team will meet with you to undertake the assessment and complete a ‘decision support tool’. You may hear this term shortened to a DST.
The Decision Support Tool (DST)
The decision support tool allows the multi-disciplinary team to gather a full picture of your health and care needs by looking at 12 different areas:
- Breathing
- Nutrition
- Continence
- Skin
- Mobility
- Communication
- Psychological and Emotional Needs
- Cognition
- Behaviour
- Drug Therapies and Medication: Symptom Control
- Altered States of Consciousness
- Other significant care needs to be taken in consideration
These care needs are then considered against the NHS Continuing Healthcare 4 key indicators to assess whether the individual has a Primary Health Need and should therefore be recommended eligible for NHS Continuing Healthcare.
Anyone over 18 years of age, assessed as having a ‘primary health need’, should be eligible for NHS Continuing Healthcare. It is not dependent on a particular disease, diagnosis or condition.
A ‘primary health need’ is a concept, rather than a legally set definition. It was introduced by the Secretary of State for Health, to assist in identifying whether a person’s primary need is for healthcare (therefore being the duty of the NHS to provide under the 2006 Act) rather than for social care (under the Care Act 2014).
A primary health need would be indicated by the nature, complexity, intensity or unpredictability of health needs, or a combination of these.
Nature, Complexity, Intensity and Unpredictability are also known as the NHS Continuing Healthcare 4 key indicators.
NHS Continuing Healthcare: 4 Key Indicators
Nature: this describes your needs and the type of needs e.g physical, psychological, etc. Nature also describes the effects of your needs on you and the type of help you may require to help manage and meet your needs.
Intensity: this considers the extent and severity of your needs and the type and level of support you need to meet them, which includes the need for ongoing or continuous care.
Complexity: this describes how your needs may interact or affect each other, which may make them difficult to manage or control. It also looks at the level of skill required to monitor your symptoms, treat your condition and/or manage your care.
Unpredictability: this looks at how your needs may vary and fluctuate and how a difficulty in predicting changes in your needs might create challenges in being able to manage or meet them. This includes the risks to your health if adequate and timely care is not provided.
The Final Eligibility Decision
The multi-disciplinary team will put forward their recommendation with regards to eligibility for NHS Continuing Healthcare to Hampshire and Isle of Wight ICB.
A registered professional within the ICB will look at the recommendation made by the multi-disciplinary team, alongside the supportive evidence collected, and finalise or “ratify” the decision. This will usually be in line with the recommendation made, unless there are exceptional circumstances.
Once we have made a decision, we will send you a letter confirming the outcome. This letter will also include a copy of the decision support tool. If you are found to be not-eligible for NHS Continuing Healthcare you have the right to appeal the decision.
NHS Disharge to Assess Pathway
Read the leaflets here
If you are not eligible for NHS Continuing Healthcare, you may be eligible for NHS-funded Nursing Care.
NHS-funded Nursing Care (FNC) is an NHS paid contribution to meet the nursing care element of your nursing home fees. FNC covers nursing care provided by a registered nurse, if you are permanently residing within a nursing home.
The NHS pays a fixed amount each week directly to your nursing home. The amount is set each year by the Department of Health and is reviewed each year. For 2023/24 the amount is £209.19 per week.
If you pay your own fees, the weekly contribution will be deducted from your bill. If you are funded by your local authority, the amount will be deducted from the fees they pay to the nursing home.
Who may be eligible for NHS-Funded Nursing Care?
You may be eligible for NHS funded nursing care if:
- You live permanently in a nursing home
- You’re not eligible for NHS continuing healthcare but you have been assessed as needing care from a registered nurse.
How is NHS-Funded Nursing Care assessed?
If you have already had a full assessment for NHS Continuing Care (CHC), we can use the information from your CHC assessment to decide whether you are eligible for NHS-funded nursing care.
If you do need an assessment, or you haven’t already had one, we can arrange this for you.
What can I expect from an NHS FNC application?
- The Nursing Home will apply for FNC within 28 days of admission, you can prompt your nursing home to apply for FNC for you
- Once the team have received the application, our administration team will arrange for one of the CHC nurse assessors to visit the nursing home and complete a Checklist Tool
- If the checklist indicates a full assessment for NHS Continuing Healthcare is required a Multi-Disciplinary team meeting will be arranged, with FNC to be considered as part of the final outcome
- Regardless of whether the outcome is eligible or not eligible for FNC, you will receive an outcome letter
- If the outcome is eligible for FNC a review will take place annually
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1079651/nhs-funded-nursing-care-practice-guidance-july2022.pdf
A personal health budget or a ‘PHB’ is an amount of money used to support your health and well being needs, as agreed between you and your healthcare team.
The aim of a personal health budget is to give you more choice and control over the money spent on meeting your health and well being needs.
Your health and well being needs will be set out in a personalised care and support plan, which you and your healthcare team will develop together. PHB’s support the vision of a more personalised, patient-focused NHS.
What are the options for personal health budgets?
You and your health or social care professional can decide together how best to manage your personal health budget. It can be managed in three different ways or a combination of these:
- A Direct Payment – You receive the money to buy and manage your own healthcare and support. Your health or social care team must agree that this meets your needs. You have to show what you have spent it on, but you, or your representative, buy and manage services yourself.
- A Notional Budget – No money changes hands. You find out how much money is available and together with your health or social care team, you decide how to spend that money. Your agreed care and support will then be arranged
- A Third Party Managed Budget – After you have agreed your budget with your health or social care team an independent organisation (for example an independent user trust or voluntary organisation) holds the money for you and helps you organise and pay for your care and support.
How can we set up a personal health budget?
If you are eligible for a personal health budget, the following steps must be followed before your budget can be made available to you:
- Assessment of your health and well being needs and collection of information relating to the health and care services currently used to support you.
- An indicative budget will be prepared. This is a calculation needed to confirm the amount of money in your personal budget.
- Your personalised care and support plan will need to be developed. This means identifying support and services required to keep you healthy and well and meet your agreed outcomes.
- Your health or social care team will help you to decide how your personal health budget will be managed.
- Care and support will be put in place; either by you if you are managing the personal health budget yourself, or by someone else if you choose a notional or 3rd party budget.
Find out more about Personal Health Budgets in the video below from NHS England or on the NHS website.
The Hampshire and Isle of Wight CHC Co-Production group has been working together to promote client engagement and co-production since 2018 with extremely positive results. We have also seen the set-up of the wider Working Together Group in 2019 with the aim to expand collaborative working.
“The importance of co-production in improving customer service outcomes for disabled people cannot be overstated. Working with the team on Continuing Health Care and personal health budgets projects in a co-productive way has been fulfilling.” - Iain Speed, CHC Co-Production Team Member, MD of All Inclusive CIC and PEP Member.
What is Co-Production in Health and Social Care?
SCIE defines Co-Production as:
“working in equal partnership with people using services, carers, families and citizens. Co-production offers the chance to transform social care and health provision to a model that that offers people real choice and control.”
The Working Together Group
As well as the NHS CHC Co-Production group who meet on a monthly basis, we have also set up the Working Together Group. This is a wider group for those who may not be able to attend monthly meetings and aims to increase shared learning and experiences of expert service users and carers. The working together group has been vital in providing feedback for our new Information booklets and website redesign.
What have the CHC Co-Production Team been working on?
Over the past year The Co-Production group have been looking in detail at the NHS CHC service and have identified key areas for improvement, including, access to accurate and up to date information, as well as improving the review process for those with Personal Health Budgets.
The group have been able to produce a series of information booklets to support our clients through the NHS CHC process and are also working to redesign the information available on our website.
The Co-Production Blog
A series of useful webinars, articles and videos:
- Webinar on Co-Production and Communities
- Practice Example on “Nothing about Disabled People without Disabled People”
- Video: The Social Model of Disability and Co-Production
- Making Events and Meetings Accessible
- Commissioning during Covid 19 and beyond
- Co-Production Week
If you receive a letter saying you are “not eligible” for CHC funding and you feel that the appropriate procedures have not been followed, for example, that our team at Hampshire and Isle of Wight ICB have not applied the National Framework appropriately in making this decision, or your needs have been misrepresented, you have a right to appeal. You should do this within six months of receiving your decision letter. If you would like to appeal a decision you can request this in writing by contacting the address details listed in the drop-down above.
What is the NHS Continuing Healthcare appeals process?
The NHS Continuing Healthcare team in Hampshire will arrange a Local Review Meeting (LRM) with you within 35 days of the request to discuss the appeal and your views on the health needs of the individual concerned.
Following this a Specialist Practitioner will review all of the evidence, including the evidence you provide and will produce an appeals document and recommendation as to whether the original decision was sound.
If the original decision is overturned and you are found eligible the ICB will seek to provide reimbursement.
What if I am unhappy with the outcome of an appeal?
If you are unhappy with the outcome of the LRM you can refer your case to an Independent Review Panel (IRP). If you would like to refer your case, you will need to write directly to the NHS Commissioning Board in the south region for an Independent Review Panel form, at england.southeast-chc@nhs.net.
Find out more at NHS Continuing Healthcare
- On the NHS website
- NHS continuing healthcare and NHS-funded nursing care: public information leaflet
- Age UK also has lots of information on their website.
- Who pays? document
- Public information document