NHS Continuing Healthcare (CHC): An Overview [HTML] | GOVERNMENT OF WALES (2023)

If you need long-term care, the type of care you need may be the responsibility of the NHS, local authority social services or both. Sometimes it will be obvious who will be responsible for your care, but if you have complex care needs, you may be able to get a combination of services from each of these organisations. This leaflet is about services funded by the NHS.

National Health Service

All NHS services are free, so if you're eligible for CHC, the NHS will pay for all your healthcare and most social care, including accommodation (in a nursing home). The Local Health Board (LHB) is responsible for organizing the assessment process to determine whether you are eligible and, if so, will plan and deliver the CHC care package. If you are found to be eligible for CHC, the NHS will cover:

  • If you live at home, the NHS pays for health care, such as the services of a community nurse or specialist therapist, and related social care, such as help with laundry and dressing. This does not include the cost of accommodation, meals or general household support.
  • If you live in a care home, the NHS will make a contract with the care home to pay fees to cover your accommodation and assess your health and personal care needs.

local administration

Local authorities (LAs) are responsible for providing information, advice and help with care and support. If you do not have basic health needs, care and support can be provided by local authorities through social services. The right to social care is set out in the Social Care and Services (Wales) Act 2014. These services are means-tested, which means that depending on your financial situation, you may have to pay for care and accommodation.

(Video) Social Care Law Lecture Series - NHS Continuing Health Care & Law

Do I have to pay for a nursing home if I qualify for CHC?

The NHS will pay for your accommodation and assess your health and personal care needs. There may be circumstances where you choose to pay your nursing home for additional services, such as additional physical therapy (in addition to those agreed in your care plan). Other examples include a more expensive type of accommodation (larger room) or "extras" such as a daily newspaper. These are sometimes called "top-up" benefits and are a separate, private payment agreement you make with your care provider at your nursing home. In this section you can find out more about the different types of accommodation and whether you will have to pay for them."How CHC is organized"

Any decision to purchase additional services should be based on personal choice and not on a lack of adequate NHS funding to meet the needs identified in the CHC care plan.

If you receive a request from your health care provider to fund additional services that you did not agree to, contact your LHB immediately to resolve the issue.

The evaluation process for HCC can be complex. Think about who you would like to support throughout the process. Many people find that there are things they don't quite understand; the assessment is about your needs and what's best for you, so you can ask questions at any time. You will probably have to discuss sensitive topics. It is important that the conversation is clear and open. A team of health and social care professionals known as a multidisciplinary team (MDT) will work with you to assess your needs (see“How Eligibility for CHC is Assessed').


An ombudsman is someone who can help you express your views during the assessment process. Hiring an ombudsman can help you manage the HCC process better and more confidently. In addition to helping you better understand your role in the CHC process, a lawyer can also help you understand the consequences of the choices and decisions you make. You can designate someone to represent your views or speak on your behalf. This could be a family member, friend, local ombudsman or other independent person who is willing to act as ombudsman on your behalf. LHB should inform you about local advocacy services.

It is important to understand the difference between a lawyer's role and a lawyer's roleCare Coordinator.A care co-ordinator is likely to work for a local health board or authority and will not be independent. LHB and Los Angeles should let you know about a local counseling center that can offer advice and support.

Information on how to contact LHB, how to make a complaint and other useful contact details, including advocacy support.

(Video) 154: How to apply successfully for NHS Continuing Healthcare, with Jacqueline Berry


Od vas će se tražiti da date informirani pristanak za proces procjene CHC-a. Kako biste dali informirani pristanak, vaš će se koordinator skrbi sastati s vama kako bi vam objasnio cijeli postupak i osigurao da imate dovoljno informacija za donošenje odluke.

You have the right to refuse a CHC assessment or later refuse a CHC offer after an assessment. LHB and LA will work with you to ensure your full understanding and minimize risks wherever possible. They should advise you of the possible impact this will have on LHB's or Los Angeles' ability to provide appropriate services. The NHS will continue to provide free health services, for example GP and district nurse services. However, LHB cannot take responsibility for organizing and financing free social welfare services, as HZK would. You can change your mind later.

You can get a joint/shared care package from LHB for any health care component or from Los Angeles for any social care component. LHB and Los Angeles will work with you to develop a joint custody plan that meets all of your assessed needs. You can find more about joint care packages in the section"What happens if I don't qualify for CHC"

If you are unable to give your consent, staff will check whether you have a permanent representative (health and social services) appointed to act on your behalf or whether the Court of Protection has appointed someone to act as a personal care assistant. Otherwise, the person conducting the assessment at this stage will be responsible for making a decision based on the best interests of the child. In these circumstances, a decision must be made as to whether it would be in the best interests of the individual to continue with the assessment and exchange of information or to delay obtaining consent until recovery. They usually consult with family and friends. If there are no family or friends, an independent mental capacity adviser will be provided.


Throughout the CHC process, you have the right to use the language/format or method of your choice for communication and participate fully as an equal partner in the assessment of your needs and the organization of social and health care.

(Video) How to prepare for an upcoming NHS Continuing Healthcare Assessment - Ridley & Hall Solicitors

The requirements for the Welsh language are set out in the Welsh Government's Welsh Language Strategy Framework 'More than just words'. Your request to communicate in Welsh should not delay CHC's assessment of admissibility, as there are specific Welsh language standards that require both your local authority and LHB to provide this.

The same considerations apply to British Sign Language (BSL) and other languages ​​and formats such as Braille.


A carer is someone of any age who provides free support to family members or friends who could not live without them. It could be caring for a friend or family member who cannot cope without your support due to illness, disability, mental health problems or addiction.

If you have a carer and your local authority thinks they need support, your carer has the right to have your needs assessed by the local authority. The LHB and LA authorities must inform you of this right. Carers may be entitled to support to help them fulfill their role as carers. Never assume that your caregiver is able or willing to continue providing support.

(Video) Continuing Healthcare


1. CHC Funding In 2022
(Help & Advice)
2. On the Edge - part 8: Interview about NHS Continuing Healthcare
3. Hospital discharge and NHS continuing healthcare - Alzheimer's Society podcast December 2015
(Alzheimer's Society)
4. Board to Board Meeting BCUHB and North Wales CHC
(BCU Live Stream)
5. Board to Board Meeting BCUHB and CHC
(BCU Live Stream)
6. Board to Board Meeting BCUHB and North Wales CHC
(BCU Live Stream)


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