Ten myths about NHS Continuing Healthcare

Wrong, and it is the most damaging myth of all. NHS Continuing Healthcare is not means-tested. Savings, income, pensions and property are entirely irrelevant to eligibility.

The confusion comes from local authority funding, which is means-tested at £23,250 in England. Families are frequently told they are “self-funders” and conclude that settles the matter. It doesn't. Being wealthy has never disqualified anyone from CHC.

Also wrong. No diagnosis qualifies automatically — not dementia, not Alzheimer's, not Parkinson's, not motor neurone disease.

Eligibility is a legal test about the nature, intensity, complexity and unpredictability of a person's needs. Two people with identical diagnoses can reach opposite outcomes. What matters is what the condition causes day to day, and how much skilled intervention is needed to manage it.

Care homes have no duty to advise you about NHS funding, and many staff do not know the framework in detail. Nor do most GPs or social workers.

The NHS is the only payer in this system that isn't required to introduce itself. Councils means-test you. Care homes invoice you. Nobody has an obligation to knock on the door and say “this might not be yours to pay.”

A refusal is a decision, not a verdict. It can be challenged through local resolution with the Integrated Care Board, then an Independent Review Panel convened by NHS England, then the Ombudsman.

A great many refusals are overturned. But an appeal must normally be brought within six months of the decision letter, and that is the deadline families most often miss.

The claim survives death. Where fees were wrongly paid, the executor or administrator can pursue it and any refund goes to the estate.

Because these claims can span years, they are frequently the largest single asset in an estate that nobody knew existed. Worth establishing before the estate is distributed rather than after.

This one reverses the truth. The National Framework requires needs to be recorded at the level they would be without the care currently in place.

A calm afternoon is the product of the low bed, the sensor mat, two carers for every transfer, the hoist standing ready and medication given on time. Strip those away and the need is plainly visible. Scoring a well-managed need as a minor one is, in our experience, the single most common reason a claim fails when it should have succeeded.

Continuing Healthcare can be provided in any setting outside hospital — a nursing home, a residential home, a hospice, or a person's own home. The setting does not determine eligibility.

Nor does the type of home someone happens to be living in. What matters is the needs, not the address.

The Checklist is only a screening tool. It decides whether someone gets a full assessment — it does not decide eligibility, and its threshold is deliberately low.

A negative Checklist that stopped the process is worth scrutinising precisely because a case screened out at that stage never reaches proper consideration at all.

CHC funds a package of care based on assessed needs. It does not automatically mean moving, and in many cases the person stays exactly where they are with the NHS meeting the cost instead of the family.

Where a change is proposed, you are entitled to be involved in that discussion and to have the person's wellbeing taken into account.

You don't, and we would rather say so plainly. You can request an assessment from your Integrated Care Board yourself, free of charge, and many families do exactly that and succeed.

Specialist help earns its place where the case is complex, where records are incomplete or being withheld, where a previous decision needs challenging, or where you simply do not have the capacity to run it alongside caring for someone. Anyone who tells you it cannot be done without a solicitor is selling you something.