Age UK has condemned the NHS Continuing Healthcare (CHC) system, calling it “a complete con” and accusing decision-makers of operating on an “ad-hoc” basis. Research highlights that thousands of people are losing NHS funding for their care after exceeding life expectancy predictions.
CHC is an NHS-funded care package for individuals with a “primary health need.” Terminally ill patients or those with rapidly declining health can access fast-track CHC, while those with ongoing but less immediate needs are eligible for standard CHC. However, eligibility is determined locally by assessors under Integrated Care Boards (ICBs), leading to wide regional disparities.
Disparities and declining support
Age UK’s report reveals that access to CHC varies drastically. In some areas, 58% of applicants receive support, while in others, the figure drops to just 5%. This inconsistency disproportionately impacts families, who describe the process as opaque and arbitrary.
PA news agency analysis of NHS data shows a significant decline in long-term CHC funding. From September 2018 to September 2024, the number of individuals deemed eligible for standard CHC fell by 37%, from 16,599 to 10,538. Meanwhile, the rise in CHC eligibility is primarily attributed to fast-track cases, intended for short-term support.
Freedom of Information (FOI) data reveals that many patients receiving fast-track CHC lose funding after reviews—even when their needs remain unchanged. Between July 2022 and December 2023, the following outcomes were reported:
County Durham: Of 2,662 reviews, 1,170 people lost eligibility, while 756 retained funding.
Tees Valley: Of 3,170 reviews, 1,096 lost eligibility, while 1,350 remained eligible.
Cheshire and Merseyside: Of 774 reviews, 172 lost eligibility, while 350 retained funding.
South Yorkshire: Between 2021/22 and February 2023, 343 of 581 reviews resulted in loss of eligibility.
In many cases, patients are shifted to NHS-funded nursing care, which is provided at a lower rate.
Pressures on the system
Age UK warns that many older adults with chronic health conditions and significant care needs are being wrongly excluded from CHC, resulting in burdensome care costs. The charity’s report argues that CHC, meant to support people with complex needs, is becoming increasingly inaccessible as financial pressures mount on ICBs to cut costs.
Although eligibility decisions are supposed to be independent of budgets, Age UK claims financial considerations often influence outcomes. The report calls for greater transparency and consistency in CHC assessments to ensure fair access for those in need.
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