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Last updated: April 2024

Adults in England with long-term complex health needs may qualify for NHS Continuing Healthcare (CHC). This is free social care arranged and funded solely by the NHS.

To get this funding a person has to have particularly intense, complex or unpredictable care needs. There is a detailed assessment and decision-making process to establish whether someone has a ‘primary health need’.  This means their care needs are primarily for healthcare rather than social or personal care. They also have to meet the criteria for this funding.

Eligibility for CHC depends on a person’s individual needs and not on any particular diagnosis or condition. To be eligible, a person must be assessed by a team of healthcare professionals. How this is done is set out in The National Framework for Continuing Healthcare and NHS-funded Nursing Care.

If as a child you have had a Health Continuing Care Package for Children with Complex Needs (see the tab on this page) there is no guarantee the NHS will continue to fund your care at the same level. You will need to be reassessed as an adult.

Beacon: gives advice, guidance and tips about assessments and appeals. It also has a free help-line.

If you do have a primary health need and are eligible for NHS Continuing Healthcare, the NHS is responsible for commissioning a care package that meets your needs. Your assessment will have considered your specific needs. Any resources offered to support you should take into account how you wish your assessed needs to be met. Depending on your situation, different options could be suitable including support in your own home and the option of a personal health budget.

For more information:

NHS.UK: Continuing Healthcare

Getting Ready for Your Assessment

To prepare, we suggest:

  • Keep a diary for a week recording your care needs throughout the day and night. Record details of the time all these tasks take you on your worst day. This blank diary template may be helpful.
  • Gather as much evidence of your care needs as you can – from doctors, other medical professionals etc. SMA UK can provide a letter of support.
  • Think about any safety issues that mean a trained Personal Assistant must be present and watchful – e.g. if there is a risk you may vomit when using BiPap and there is a danger of choking.
  • Think about any emotional or psychological challenges for you as well as physical challenges.

Your medical team should provide information about your  condition.

Please contact SMA UK if you:

  • would like more help to explain the impact your SMA has on you and your family
  • need any other support preparing for or during your assessment.

The people who work with you to assess your care needs should keep you well informed about:

  • who is doing what
  • how long the assessment will take
  • how any decisions and offers of care will be made to you.

If you are not sure what is happening at any stage, ask your assessor.