Home › CHC funding withdrawn

Has NHS Continuing Healthcare funding been withdrawn after review?

A CHC review is not supposed to be an automatic fresh eligibility test. Its normal focus is whether the existing care package still meets the person's needs. If needs have changed enough to call eligibility into question, the ICB may arrange a full reassessment.

The point to check first

National public guidance says reviews should normally take place within three months of a positive eligibility decision and then as required, at least annually. If eligibility is going to be reconsidered because needs have materially changed, that should be dealt with through the proper reassessment process.

What a routine review should focus on

Is the care plan still right?

The review should look at whether the care package and arrangements remain appropriate to meet the person's current needs.

Have the needs materially changed?

The most recent Decision Support Tool is normally used as a reference point. A full reassessment may follow where the change could affect eligibility.

Questions to ask if funding is removed

What specific needs are said to have reduced or changed?
Is that conclusion supported by contemporaneous care records rather than a short snapshot?
Was a full reassessment carried out where eligibility was being reconsidered?
Were the nature, intensity, complexity and unpredictability of the current needs considered together?
Were successful interventions wrongly treated as proof that the underlying need disappeared?
Were the reasons for the change explained clearly in writing?

Well-managed needs are still needs

The Decision Support Tool guidance says needs should not be marginalised simply because they are successfully managed. The fact that medication, supervision, specialist care or a structured plan is preventing incidents can itself be important evidence of the need that continues to exist.

Funding should not simply vanish

The government's public CHC leaflet states that neither the NHS nor the local authority should withdraw from an existing care or funding arrangement without a joint reassessment of needs, consultation about the proposed change, and alternative funding or services being put into effect.

A practical review of a withdrawal

Get the decision and review documents

Obtain the written reasons, review notes, latest DST and the records said to justify the change.

Compare old and new needs

Identify what has genuinely changed and what is simply being managed more effectively. The two are not the same.

Check the process

If the review moved into a reassessment of eligibility, examine whether the correct multidisciplinary process and evidence were used.

Challenge the decision where justified

The decision letter should explain the available review or appeal route. A focused challenge should address both the evidence and any material procedural defect.

When the case is particularly worth examining

Funding withdrawals deserve close attention where the person's diagnosis has not changed but the ICB says the needs have reduced, where high levels of care are preventing incidents, or where the new scoring appears inconsistent with the care plan and daily records.

Primary sources: GOV.UK — CHC public information leaflet · GOV.UK — Decision Support Tool guidance

Has funding been stopped or reduced?

We can review what changed, what evidence the ICB relied upon and whether the review or reassessment properly reflected the ongoing needs.

Start the free check →

Care Home Cost Claims is operated by Christodoulos Ltd (trading as Theodorous), The Barbon Buildings, 14 Red Lion Square, London WC1R 4QH. Authorised and regulated by the Solicitors Regulation Authority under SRA number 809508. General information only; no outcome is guaranteed.