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The Process

Appeals and Challenges

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The Process

Appeals and Challenges

Contact

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The Process

Appeals and Challenges

Contact

A detailed infographic explaining how CHC decisions are made, emphasizing a structured process from gathering evidence to reaching a professional judgment. The infographic highlights six steps: gather evidence, rate each domain, consider NICU needs, consider totality and interaction, apply professional judgment, and reach a recommendation. It also discusses the importance of evidence, context, and professional judgment in decision-making.

Informational poster explaining NICU (Needs, Intensity, Complexity, Unpredictability) characteristics used to understand the nature of needs. It features descriptions, key questions, and guidance on how NICU informs professional judgment, emphasizing that the decision support tool helps organize evidence without making decisions solely by score.

An informational infographic about the concept of 'Totality of Need' in health care, emphasizing understanding the whole person beyond just individual needs, with sections on considering the bigger picture, examples of totality like psychological, physical, cognitive, and communication needs, and a key takeaway about the importance of understanding the whole person for making decisions.

Infographic explaining the interaction of needs model in healthcare, emphasizing the importance of interactions between needs and their impact on the person, with sections on how needs interact, the concept of cumulative impact, and examples of interactions such as cognitive, physical, psychological needs, and the importance of considering overall impact.

An infographic from CHC Clarity explaining the pattern recognition model used in healthcare decision-making. It outlines six steps: gather evidence, analyze the whole, recognize patterns, interpret meaning, professional judgment, and reach a decision. The infographic also includes definitions, reasons why pattern recognition matters, examples of patterns professionals recognize, and key takeaways.

An infographic poster for CHC Clarity explaining what the CHC Framework says and doesn't say. It highlights that the framework is person-centered, evidence-informed, judgment-based, and focused on outcomes. It emphasizes that it does not give automatic answers, replace professional judgment, focus on diagnosis or labels, set fixed thresholds, or stand alone. The poster outlines how the framework fits within the wider system, including wider information, informed analysis, professional judgment, person-centered decision, and appropriate support. It states that the framework helps make sense of complexity and supports fair and consistent decisions, but it does not replace judgment. The poster ends with a key takeaway that the framework provides clarity and consistency, enabled by judgment.

An informational poster from CHC Clarity explaining the process of decision-making in healthcare. It includes six steps: gather evidence, rate each domain, consider NICU, consider totality and interaction, apply professional judgment, and reach a recommendation. The poster emphasizes evidence-based decisions based on understanding the person's needs, evidence accuracy, context, and professional judgment.

Welcome to CHC Clarity

NHS Continuing Healthcare, explained clearly.

If you are trying to understand CHC for the first time, the process can feel confusing very quickly. You may hear words like Checklist, DST, domains, Primary Health Need and eligibility — without anyone properly explaining what they mean.

Our niche

We cut through the jargon so families can understand what CHC is really asking.

CHC is not just about whether someone needs care. It is about whether their overall needs are mainly health needs, and whether responsibility for their care should sit with the NHS rather than social care.

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Plain English

We explain CHC terms in a way that makes sense, without assuming you already understand the system.

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Clear direction

We help you understand where you are in the process and what each stage is actually for.

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The whole picture

CHC is not about one word, one diagnosis or one score. It is about the overall picture of need.

What is CHC?

NHS Continuing Healthcare is a package of care arranged and funded by the NHS for adults who have been assessed as having a Primary Health Need.

Put more simply: CHC asks whether the person’s care is mainly about managing health needs and health risks, rather than support that can properly sit within social care.

Social care

Supporting someone to live their daily life.

Social care often supports a person with everyday living.

Examples: washing, dressing, toileting and meals.

Examples: prompts, supervision, routines and staying safe at home.

Examples: support to maintain independence, wellbeing and ordinary daily life.

CHC

Support with health needs to help someone live safely.

CHC looks at whether the person’s health needs, risks and care requirements mean the NHS should be responsible.

Examples: swallowing risk, pressure damage, unstable breathing or severe pain.

Examples: needs that change quickly, interact with each other or require close monitoring.

Examples: care that is mainly about managing health risk, not just daily support.

Why does this matter?

Because many families are told someone “does not qualify” without fully understanding why. Our aim is to make the process easier to follow, so you can understand the words being used, the evidence being considered and the question being asked.

CHC, put simply.

We are explainers. We help turn complicated CHC language into clear, practical understanding — so families can see what matters, what questions to ask and how the pieces fit together.

Understanding CHC

What is CHC?

CHC stands for NHS Continuing Healthcare. It is funding from the NHS for adults who have significant care needs because of their health.

Put simply: CHC is about whether a person’s care needs are mainly health needs, rather than social care needs.

The simple explanation

CHC is not just about having a diagnosis.

Someone does not automatically qualify for CHC because they have dementia, Parkinson’s, cancer, a stroke, a disability, or another medical condition. What matters is how their condition affects them, what care they need, how much risk there is, and whether their needs are mainly health-related.

It looks at the person’s needs

CHC looks at what support the person actually needs day to day, not just the name of their illness or condition.

It looks at the level of risk

The assessment should consider whether the person’s needs are difficult to manage, change quickly, or need careful monitoring.

It looks at the whole picture

Needs should not be looked at one by one only. The overall picture matters, especially when several needs affect each other.

What CHC can pay for

If someone is eligible, the NHS pays for their care.

CHC can fund care in different places. It is not limited to a hospital or nursing home.

At home

A person may receive NHS Continuing Healthcare in their own home if they are assessed as eligible.

In a care home

CHC can also fund care in a residential care home or nursing home, depending on the person’s assessed needs.

Common confusion

CHC is not means-tested.

This means CHC is not based on a person’s savings, income, house, pension or financial situation. The question is whether the person has the type of health needs that mean the NHS should be responsible for funding their care.

It is not about savings

A person should not be refused CHC simply because they own a home or have savings.

It is not a simple score

CHC assessments use paperwork and care domains, but eligibility is not just about adding up scores.

The key question

Is the person’s care mainly about health?

This is the heart of CHC. The assessment should look at whether the person’s needs are more than ordinary social care needs.

How serious are the needs?

Are the needs severe, frequent, or difficult to manage safely?

How complex are they?

Do different health issues affect each other or make care harder to plan?

How quickly can things change?

Does the person’s condition change suddenly, creating risk or needing urgent changes to care?

CHC, put simply.

NHS Continuing Healthcare is about whether a person’s care needs are mainly health needs. It is not based on diagnosis alone, where someone lives, or how much money they have.

At CHC Clarity, we help families understand the process, the language and the evidence, so they can feel clearer about what is being assessed.

The real CHC question

What is CHC really asking?

CHC can feel confusing because families are often shown forms, scores and care domains. But underneath all of that, the question is much simpler.

The central question

Are this person’s care needs mainly the responsibility of the NHS, or can they properly be met by the Local Authority through social care?

Local Authority responsibility

Local Authorities arrange and fund social care for adults who need support with daily living, where the person is eligible under the Care Act and financial assessment rules.

This can include support with personal care, daily routines, safety, meals, mobility, social needs and practical support.

Put simply: social care is usually about helping someone live day to day with support.

It may include significant care, but it must still be within what a Local Authority can lawfully provide.

NHS responsibility

The NHS is responsible where the person’s overall care needs are primarily health needs.

This may be because the person’s needs are serious, complex, intense, unstable, unpredictable, or require a level of clinical oversight that goes beyond ordinary social care.

Put simply: CHC asks whether the person’s care is mainly about managing health needs and health-related risk.

If the person has a Primary Health Need, the NHS should fund the full package of care.

The boundary is not always obvious.

Many people need both health care and social care. The difficult question is not whether health needs exist, but whether the overall level and type of need means the NHS should take responsibility for funding the care package.

This is why CHC decisions should not focus only on diagnosis, individual scores, or where someone lives. They should consider the person’s needs as a whole.

Helpful questions to ask

What care is actually needed? Look at the person’s daily care, supervision, monitoring and support needs.

What risks are being managed? Consider what could happen if care is delayed, missed, or not delivered correctly.

How complex is the care? Think about whether different needs interact and make the care harder to manage.

Who should be responsible? Ask whether the overall picture sits more properly with social care or NHS-funded care.

CHC, put simply.

CHC is really asking where responsibility sits. Is this care mainly social care, or has the person’s overall level of need crossed the boundary into NHS responsibility?

CHC, put simply.

Once the language becomes clearer, the process becomes easier to follow. The key is not learning every technical phrase, but understanding what each term means for the person’s real care needs.