NHS Continuing Healthcare

NHS Continuing Healthcare (NHS CHC) is a package of care for adults aged 18 or over which is arranged and funded solely by the NHS. In order to receive NHS CHC funding individuals, have to be assessed by integrated commissioning boards (ICBs) according to a legally prescribed decision making process to determine whether the individual has a ‘primary health need’.

This process is set out in the The National Framework published by the Department of Health and Social Care and is underpinned by the NHS Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 as amended.

The Department of Health and Social Care has produced a helpful public information leaflet and guidance on previously unassessed periods of care.

Any individuals wishing to find out more about the NHS CHC process in their local area should contact their ICB. Information on finding your local ICB and relevant contact details can be found on nhs.uk

Information and advice service

NHS England recognises that information and support are vital to all individuals involved in the CHC process and so has funded an independent information and advice service through a social enterprise called Beacon. This service is supported by a consortium of leading voluntary sector organisations including Age UK, Parkinson’s UK and the Spinal Injuries Association.

Information and advice is accessible in the form of free and comprehensive written guidance, and individuals are also able to access up to 90 minutes of free advice with a trained NHS continuing healthcare adviser 0345 548 0300.

For further information and to access this service please see the Beacon website.

NHS England’s role and statutory function

NHS England is required to establish arrangements for the independent review of integrated commissioning boards (ICBs) decisions on eligibility for NHS Continuing Healthcare funding. The right to request an independent review from NHS England rests with individuals and/or their representatives. ICB’s should notify the individual and/or their representative of this right when sending the final decision letter.

Before an independent review is set up it is particularly important that all appropriate steps have been taken by the relevant ICB to resolve the case informally. If the case cannot be resolved by local resolution the applicant or their representative may ask NHS England to arrange an independent review.

The independent review process is co-ordinated by the NHS Continuing Healthcare teams in each of the seven regions of NHS England.

Once it has been determined that a case is ready for independent review, the chair (seeking independent clinical advice if required) will look at the case to determine whether a full panel will proceed.

Independent review panel

An independent review panel (IRP) is made up of:

  • an independent chair
  • a representative nominated by an integrated commissioning boards (not involved in the case);
  • a representative from a Local Authority (not involved in the case); and
  • at times there is also a clinical advisor in attendance.

CHC Independent Review Panels are normally held online (virtually) on Microsoft Teams. Individuals can request telephone, face to face and hybrid versions of IRPs and these requests will be considered by NHS England on a case-by-case basis.

For further information please refer to the Independent review process – public information guide.

Here are the contact details for our regional teams: