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Continuing Healthcare Assessment: Things to Remember

Continuing Healthcare Assessment: Things to Remember

The NHS continuing healthcare assessment can often be a troubling time for those involved due to some families being refused. However, it is important to be as prepared as possible, as well as understanding the process itself.

Here at Compass CHC, we want to ensure that those who go through this process are prepared and understand the process, as we know that this can be a difficult time for the families involved. The assessment itself can be difficult to understand, so we have created this guide of things you should think about before the assessment takes place.


The first thing to remember is that eligibility for continuing healthcare is not based on current diagnoses. For example, if an individual has been diagnosed with Alzheimer’s disease, Parkinson’s disease or another degenerative condition this doesn't mean that they will be assessed as having a primary health need. Instead, eligibility is determined by assessing day-to-day care needs and how they should be met.

Depending on the progression of the illness, a person with dementia or any other illness can often have many health and social care needs, some of which may be complex, intense or unpredictable in their nature. If one health need or a number of needs are assessed as being complex, intense or unpredictable this will mean that their primary need is a health need, then they should be eligible for continuing healthcare.

“You Can Never Know if Yourself or a Loved One is Eligible” 

We can often hear that families have been given false promises about their chances of being eligible by health and social care professionals such as doctors and consultant who don't necessarily understand the continuing healthcare criteria. However, attitudes towards continuing healthcare within the medical community can vary.

Unless the professional has spent time working within the dedicated field of NHS continuing healthcare, it is unlikely that they will fully understand it. Eligibility is, however, based upon there being a primary health need which is established through the assessment process where a multidisciplinary team will assess yours or a loved one's needs.

It is important to remember that until this assessment has taken place, no-one can tell you if you are eligible or not, not even your GP.

Financial Situation Should Not Be Taken into Account

We cannot stress how important this particular statement is, as according to the 1964 NHS Act, nursing care in England must be free at the point of delivery. This means that if you or a loved one have been assessed as having a primary health need, then by law, the NHS must pay the full costs of the care required.

NHS continuing healthcare is not means tested which means that a person’s financial status must never be taken into account. Assessors should not ask you questions about your financial situation, and if they do, you do not have to answer them because they do not need that information in order to assess your health needs.

The NHS Continuing Healthcare National Framework is clear about this issue and makes requirements to ensure that decisions regarding eligibility are free from financial influences.

Continuing Healthcare is Not for Life

As continuing healthcare is based on an assessment of care needs and how those needs should be met rather than on a specific diagnosis, it is common for these needs to change over time. Therefore, if yourself or a loved one has been assessed as eligible, you can then expect your needs to be reviewed three months after the original decision, and annually after that. Unfortunately, this means that it is possible for individuals to ‘drop out’ of funding at a later stage despite having similar needs.

Tim Davies, non-practising solicitor and managing director of Compass CHC says:

“Being prepared for the assessment process for continuing healthcare funding can often be the difference between success and failure. Understanding what is relevant and what to focus on and to bring to the attention of the assessor, and what is not relevant is crucial. At Compass CHC we are able to draw upon a wealth of experience and expertise surrounding continuing healthcare and are here to provide assistance in any way we can, wherever you find yourself in the process”.

Here at Compass CHC, we can help you understand the continuing care assessment process as well answer any questions you may have regarding the continuing healthcare. Our experienced team is on hand to assist you in securing funding for yourself or a loved one. If you need any help regarding this matter, then please do not hesitate to get in touch with us today.

Author: Fiona Gilbert BSc (Hons), MA

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Do not delay, contact us today. We specialise in securing funding from day 1 and assisting families with the process from the outset. Don’t wait until a negative decision has been made and it is then necessary to have to appeal the outcome. This can take many months and all the while the patient will be having to pay the cost of their care.

Did you know?

If an individual is approaching the end of their life then a “fast track” Continuing healthcare funding assessment may be appropriate. This enables the individual to receive prompt NHS funding to meet the cost of care at the end of life stage.

What is Continuing Healthcare?

Click the video to see a detailed explanation.

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