Continuing healthcare for adults

NHS continuing healthcare

Some people aged 18 and over with long-term complex physical or mental health needs qualify for care arranged and funded solely by the NHS. This is known as NHS continuing healthcare. 

Your eligibility for NHS continuing healthcare depends on your assessed medical needs and whether you need substantial ongoing healthcare. It is not based on any particular diagnosis or condition. If your needs change, your eligibility for NHS continuing healthcare may also change. 

NHS continuing healthcare can be provided in a variety of settings outside hospital, such as in your own home or in a care home. 

As this is a health funded service the money you receive for continuing healthcare does not depend on your savings or income. 

The NHS website has information about continuing care assessments including who is eligible and how people are assessed.

Timescales for NHS continuing care assessments

There has been a big increase in requests for NHS continuing healthcare and NHS, including retrospective requests. 

In most cases, the full assessment and decision-making process should be no more than 28 calendar days from the date that the initial assessment gives a recommendation to proceed. Continuing healthcare teams in Hertfordshire and West Essex are working hard to respond to requests as quickly as possible. However, due to the volume of assessments the process can sometimes be longer, especially for retrospective requests. 

If you need an urgent decision, for example if your health is rapidly deteriorating or your illness is entering a terminal phase, we can ‘fast track’ your assessment to make sure you get the healthcare you need quickly. 

NHS funded nursing care

If you do not qualify for NHS continuing healthcare and are living in a care home where there is nursing care, you may still be entitled to a contribution from the NHS to meeting the nursing element of your care.  

This is called NHS funded nursing care (FNC) and is available for people who need to have a registered nurse involved in their care. Being a resident in a care home with nursing does not automatically make you eligible for funded nursing care.  

If you receive FNC, it will be paid to the care home directly. It will fund care that is provided, supervised, or planned by registered nurses that are employed by the care home. If you are self-funding your care at the nursing home, your care home fees should show what you are paying for healthcare. 

Please talk to the manager of your home to discuss how funded nursing care affects your fees. If your placement is funded by adult social care, the funded nursing care payment forms part of the fees paid to the care home and does not affect or change any contribution from your pension or third party top up fees.

Care and support planning

If you are eligible for fully funded NHS Continuing Healthcare, the next stage is to arrange a care and support package which meets your assessed needs either in a nursing home or your own home. We will discuss and agree this with you and your family or representative. 

• If you get NHS Continuing Healthcare at home, adult social care services may still be responsible for providing some support services for you or your carers. You can have ‘mixed’ packages of care, where some services come from the NHS and some from adult social care services. If adult social services provide care for you, they will usually do a financial assessment to decide whether you need to make a financial contribution. 
• If you are eligible for NHS Funded Nursing Care, the continuing healthcare team will work with you and your family to find a nursing home that can meet your needs. 

Reviewing your care

Your care needs may change over time. If you receive NHS Continuing Healthcare, or NHS Funded Nursing Care we will do a review after three months to check that your existing care and support package meets your assessed needs. We will do further reviews at least once a year after that. 

If your care needs have changed, the review will consider if your funding needs to change. It may consider if you are still eligible for fully funded NHS Continuing Healthcare. If you are getting NHS funded nursing care and your needs have increased the review might decide that you should be reassessed for fully funded NHS care.

For more information and to see if you are eligible for support

If you think you may be eligible for either NHS continuing healthcare or NHS funded nursing care and you are registered with a GP in Hertfordshire or West Essex please speak to your social or care worker, GP or other health or social care professional and ask for a continuing healthcare checklist. 

If you have any further queries about continuing healthcare in Hertfordshire and west Essex you can also contact your local team for more information and advice.

Contact the continuing healthcare team

If you phone continuing healthcare and the line is busy, please leave a voicemail message with your contact details. A member of our team will call you as soon as they are free.