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NHS Continuing Healthcare: prepare for your assessment

NHS Continuing Healthcare is fully funded care with no means test. Eligibility is decided across 12 care domains. Score each one honestly, on a bad day rather than a good one, and note the evidence you have.

Before you start: There is no list of conditions that qualify for NHS Continuing Healthcare. Eligibility is decided on your overall care needs, judged on their nature, intensity, complexity and unpredictability, not on your diagnosis.

1. Behaviour

Challenging behaviour, risk to self or others, and how predictable it is.

2. Cognition

Memory, understanding risk, capacity to make decisions about care.

This domain does not go above Severe in the Decision Support Tool.

3. Psychological and emotional needs

Mood, distress, anxiety, and how much intervention it takes.

This domain does not go above Severe in the Decision Support Tool.

4. Communication

Ability to express needs and be understood, including pain.

This domain does not go above High in the Decision Support Tool.

5. Mobility

Transfers, falls risk, positioning, and risk of contractures.

This domain does not go above Severe in the Decision Support Tool.

6. Nutrition

Swallowing problems, tube feeding, risk of aspiration, weight loss.

This domain does not go above Severe in the Decision Support Tool.

7. Continence

Catheters, stoma care, and how much skilled input is needed.

This domain does not go above High in the Decision Support Tool.

8. Skin integrity

Pressure damage, wounds, and the complexity of dressing regimes.

This domain does not go above Severe in the Decision Support Tool.

9. Breathing

Oxygen, ventilation, suction, and how quickly things deteriorate.

10. Drug therapies and medication

Complex regimes, injections, syringe drivers, symptom control.

11. Altered states of consciousness

Seizures, blackouts, episodes needing skilled intervention.

This domain does not go above Severe in the Decision Support Tool.

12. Other significant care needs

Anything significant not captured above.

This domain does not go above Severe in the Decision Support Tool.

What this tool does not do

  • It does not make a decision. Only the DWP, your council or the NHS can do that.
  • It is not the Decision Support Tool itself and carries no weight with an integrated care board.
  • It cannot weigh nature, intensity, complexity and unpredictability the way a multidisciplinary team must.
  • It is an estimate based on published rules and 2026/27 rates, not advice.

Common questions

Does this decide whether I get Continuing Healthcare?

No. Only a multidisciplinary team and the integrated care board can decide. This mirrors the structure of the Decision Support Tool so you can prepare properly, spot where your evidence is thin, and go into the meeting knowing what will be discussed.

What score means I am eligible?

There is no pass mark. As a guide, one domain at Priority, or two or more at Severe, usually indicates a primary health need. A single Severe with several High and Moderate scores may also. The team must weigh nature, intensity, complexity and unpredictability, not just count boxes.

What is a well managed need?

A need that looks small because skilled care is keeping it under control. The framework is clear that needs should be scored on what they would be without that care, not on the calm surface. This is one of the most common reasons decisions are overturned on appeal.

What if I disagree with the outcome?

Ask the integrated care board for the completed Decision Support Tool and request a local review. If that fails you can ask NHS England for an independent review. Beacon gives free independent CHC advice funded by the NHS.

Where these rules come from