Continuing Healthcare (CHC)

Section 01Service definition

Continuing Healthcare is fully NHS-funded care commissioned for adults assessed under the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care.

Provision is typically delivered in the person's own home, in residential or nursing settings, or through specialist placements. CHC packages frequently include 24-hour care, complex clinical interventions and end-of-life provision.

Section 02Typical client cohort

Adults with primary health needs across complex disability, neurological conditions, end-of-life, mental health and learning disability with health overlay. Referrals come through CHC assessment teams, hospital discharge and fast-track pathways.

Section 03Commissioning and procurement context

NHS Integrated Care Boards commission CHC packages directly. Spot purchasing dominates for complex placements; frameworks exist for high-volume CHC pathways.

Joint commissioning with local authority adult social care is common for packages crossing CHC and Care Act eligibility.

Section 04Core service requirements

Domains of Decision Support Tool understanding, Fast Track CHC compliance for end-of-life referrals, primary health need evidencing, joint protocol working with social care, and reporting against ICB performance frameworks.

Section 05Regulatory and compliance framework

National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (revised 2022), Care Act 2014 (joint working), Mental Capacity Act 2005, and CQC registration where the regulated activity applies.

Section 06Key operational challenges

Demonstrating primary health need understanding in tender responses, evidencing the Fast Track pathway, and showing how the provider integrates with ICB CHC processes.

Section 07How we approach this setting

We document the CHC referral acceptance protocol, the Decision Support Tool engagement, and the named clinical liaison route.

Section 08Typical starting points we handle

Adult social care providers stretching into CHC packages, nursing care providers responding to ICB framework refreshes, and complex care providers entering Fast Track commissioning.

Section 09Outcomes achieved

ICB framework entry, Fast Track panel inclusion, and joint health and social care package allocation.

Section 10Related case examples

The case studies below match this care setting and demonstrate the operational evidence base behind successful submissions.

Section 12Where this applies

NHS Integrated Care Boards, joint NHS and local authority commissioning, and regional CHC procurement collaboratives.