Updated 03 December 2020
If you have ongoing complex health problems that mean you require care, you may be able to get this care funded on the NHS. This funding is called NHS continuing healthcare. A form of this is also available for children with ongoing healthcare needs, and this is known as a ‘continuing care package’.
NHS continuing healthy is completely free for those who meet the necessary criteria. Recipients will generally have either a long-term physical or learning disability that makes it very hard for them to look after themselves. If you are entitled to the service, you may be cared for at home, at a residential care home or in hospital.
It is up to the NHS to decide who is eligible, based on how your condition affects your day-to-day life and health. A clinical commissioning group (CCG) will see if you qualify by carrying out an assessment in two stages: initial and full.
Your initial assessment will be a checklist completed by a nurse, doctor, other healthcare professional or social worker. You’ll then be told whether you qualify for the full assessment. If you don’t meet the initial criteria, you can ask your local authority about other forms of financial support.
During the full assessment, at least two healthcare professionals (or someone already dealing with your care) will evaluate your health and how well you can carry out a number of everyday tasks. They will want to learn about your mobility, breathing, emotional needs, communication, understanding of the world around you and other factors that affect your day-to-day life. Using the results of your assessment, they will decide whether you need the care. It could be that you have severe needs in just one aspect, or you have a range of difficulties which combine to make your life difficult.
It usually takes about 28 days for the NHS to come to a decision about your eligibility for continuing healthcare.
If you need help urgently and don’t feel you can wait 28 days, for example if your health is deteriorating quickly or you have a terminal illness, you may be able to have a quicker assessment known as the Fast Track Pathway Tool. A healthcare professional will decide if you need to be fast-tracked and will organise this for you. If you meet the criteria, you will usually be given NHS continuing healthcare within 48 hours.
The care you receive will be tailored around your own needs, and you will be consulted about the kind of care you want to have.
You might have care workers appointed for you, or you might receive a personal health budget to spend on your choice of care (as long as it meets the needs highlighted in your assessment). Alternatively you may be looked after in a residential care home local to you.
The care or funding you are offered is known as your ‘care and support package’. This package should be reviewed within the first three months and then annually to ensure that it still covers all your needs.
A similar kind of care programme is set up for children (anyone under the age of 18), and is often known as a continuing care package. It works in a very similar way, but it takes into account different services that are available to children through the NHS and local authority. Once you turn 18, you will have to be reassessed for the adult form of NHS continuing healthcare.
If you are not eligible for NHS continuing healthcare, you may be entitled to other funding from your local authority or charities. Find out more about help with paying for care.
The cost of care may still be hard to afford even for those who don’t qualify for financial help. If you are concerned about how much you are spending on care, a financial adviser may be able to help. An adviser can help you organise your finances around your care needs and so make them last as long as possible. Find out more about paying for care.