NHS continuing healthcare and NHS-funded nursing care

In England, Wales and Northern Ireland, if you have a disability or complex medical problem, you might qualify for free NHS continuing healthcare or HSC.

This covers extra costs, such as:

• help with washing or dressing

• paying for specialist therapy 

• accommodation if your care is provided in a care home 

• support for carers if you’re being looked after at home.

If you’re assessed as having a ‘primary health need’, the NHS, or HSC, is responsible for providing and funding all your needs, even if you’re not in hospital. For example, you could be in: 

• a hospice 

• a care home, or

• your own home.

In Scotland, NHS continuing healthcare was replaced in 2015 by Hospital Based Complex Clinical Care. Those receiving NHS continuing healthcare before June 2015, will continue to do so.

Ask your GP, or social worker, to arrange an assessment to see if you qualify for NHS continuing healthcare or HSC.

Your eligibility for funding is based on your assessed needs, not on a specific diagnosis or health condition. If your needs change, your eligibility might change too.

You might qualify for NHS continuing healthcare, or HSC, if you have:

• significant or ongoing health needs due to a disability, accident, or illness 

• complex care requirements that go beyond what your local council, social services, or HSC, can provide

• post-hospital discharge and need high level of care

• an existing care review has found that your needs have increased

If you qualify for NHS continuing healthcare or HSC, your local NHS authority (a Clinical Commissioning Group or Local Health Board), or HSC, will arrange a care and support package that meets your assessed needs. They might work with your local council to arrange it.

Depending on your needs, different options might work for you. This could involve getting support at home and having a personal health budget.

If you’ve been turned down for funding, make sure your situation is regularly reviewed, especially if your health deteriorates. Your GP or social worker can help you.

Even if you don’t qualify for NHS continuing healthcare, or HSC, you might still qualify for other services to support you. This might include:

• palliative care

• carer’s breaks and respite health care 

• rehabilitation and recovery

• community health services specialist support for healthcare needs.

There might be local council, or HSC, funding to meet some of your care needs. Find out more in our guide Local authority funding for care costs – do you qualify?

Ask your local Integrated care board (ICB)Opens in a new window Health Board, or HSC. for a review of their decision within six months. If the decision was based on an initial screening, request a full assessment. You can participate in the review and see the evidence.  

If you’ve been paying care home fees and believe you should have received NHS, or HSC, funding, you can appeal by asking for a retrospective assessment. If unresolved, request an independent review panel within six months. As a last resort, contact the Parliamentary Health Service OmbudsmanOpens in a new window for a final decision. In Northern Ireland, contact the Northern Ireland Public Services OmbudsmanOpens in a new window

If you don’t qualify for NHS continuing care, or HSC, and you need care in a nursing home, you might get NHS-funded nursing care or HSC-funded nursing care. For more details, see below.

NHS-funded nursing care or HSC-funded nursing care is funding provided by the NHS, or HSC, to cover the standard cost of care by a registered nurse in a care home or nursing home. It is only available if you’re in a care home.

If you've been assessed as needing nursing care in England or Wales, the NHS will pay a standard rate. It won’t pay for the other care home costs such as accommodation or food.

In Scotland, it will be paid by your local council.

In Northern Ireland, your local HSC is responsible for paying the contribution. To find outOpens in a new window more on nidirect.

You might be able to get NHS-funded nursing care, or HSC-funded nursing care if:

• you don’t qualify for NHS continuing healthcare, or HSC, but you’ve been assessed as needing care from a registered nurse, and
• you live in a care home that’s registered to provide nursing care

Ask your GP or social worker to arrange an assessment of your needs. This assessment determines if you qualify for NHS continuing healthcare, or HSC, or nursing care in a care home, with the NHS, or HSC, covering part of the nursing fees. 

This payment goes directly to the care home to reduce your overall costs or if you’re being funded by your local council, or HSC, the payment is passed to them. If you pay all your fees, the amount you pay will be reduced by the NHS, or HSC, contribution. 

If you only pay some fees, you'll still benefit. The care home should clearly show how the NHS, or HSC, funding lowers your costs - ask if it isn't clear. 

If you go to the hospital, this funding stops, but you may still need to pay to keep your room. If you no longer need nursing care, the funding might also stop. 

If you live in Scotland, download the ‘Care home funding’ guide on Age UK Scotland.

• If you get disability benefits like Attendance Allowance, Disability Living Allowance (DLA), or Personal Independence Payment (PIP), you must inform the Disability Benefits Centre if you are getting NHS Continuing Healthcare.

• If you receive NHS Continuing Healthcare in a nursing home, Attendance Allowance, and both parts of Disability Living Allowance and PIP stop after 28 days from when NHS funding starts, or sooner if you were recently in the hospital.

• If you receive NHS Continuing Healthcare in a residential home, Attendance Allowance and the care parts of Disability Living Allowance and PIP stop after 28 days from when NHS funding starts, but you still get the mobility parts of Disability Living Allowance or PIP.

• If you live at home and receive NHS Continuing Healthcare, you can keep getting these disability benefits. Make sure you are receiving the right amount. The rules can be complicated, so get advice on how NHS Continuing Healthcare affects your benefits. 
  

• State Pension is not affected by NHS Continuing Healthcare.

• If you receive Pension Credit, you lose the severe disability addition if your Attendance Allowance, Disability Living Allowance care component, or PIP daily living component payments stop.

If you’re getting a Personal Care allowance, you won’t be entitled to:

• Attendance Allowance

• the care component of Disability Living Allowance, or 

• PIP after the first four weeks. 

If you’re receiving benefits and your situation changes, you need to let your jobs and Benefits office knowOpens in a new window Find out how your benefits might be affected if you get HSC-funded nursing careOpens in a new window on nidirect.

NHS-funded nursing care, or HSC-funded nursing care, should still be paid if your stay in the care home is temporary.

If you’re staying for six weeks or less, you won’t have to be formally assessed.

Instead, your need for nursing care will be based on information the care home or your GP provides.

NHS-funded nursing care, or HSC-funded nursing care, can be a useful contribution towards costs if you need regular periods of respite care.  

For more information on NHS-funding nursing care, see Age UKOpens in a new window