For many families, paying for care can quickly become one of life's biggest financial burdens. Residential care fees can sometimes exceed £1,500 per week, while complex care packages at home can cost significantly more. Yet many people are unaware that, if their primary need is a health need rather than a social care need, the NHS may be responsible for funding the full cost of their care.

Understanding whether you or a loved one may be eligible for NHS Continuing Healthcare can make an enormous difference—not only financially, but also by ensuring that the right care is provided at the right time.

What is NHS Continuing Healthcare?

NHS Continuing Healthcare is a package of care arranged and funded entirely by the NHS for adults who have significant ongoing healthcare needs.

Unlike local authority funding, it is not means-tested. This means that eligibility is based solely on an individual's healthcare needs, not on their income, savings or the value of their home.

If someone qualifies, the NHS can fund care provided:

• In a care home
• In a nursing home
• In their own home
• In supported living or other suitable settings

Depending on individual circumstances, this can save families many thousands of pounds each year.

Why are so many people missing out?

Many people assume that because they have dementia, Parkinson's disease, a neurological condition or severe physical disabilities, funding will happen automatically.

Unfortunately, that is not how the system works.

The assessment process is detailed and highly technical. It considers numerous factors including:

• The nature of someone's needs
• How complex those needs are
• How intense those needs are
• How unpredictable they are

Small differences in how evidence is presented or interpreted can have a significant impact on the final decision.

In many cases, people who could qualify are never referred for assessment at all.

The importance of getting assessed

One of the biggest mistakes families make is assuming they are not eligible without ever having an assessment.

Even where funding is ultimately declined, an assessment can:

• Identify unmet healthcare needs.
• Ensure care plans better reflect a person's condition.
• Trigger further reviews if needs deteriorate.
• Provide clarity about future funding options.

Where funding is awarded, the financial benefits can be substantial.

Real-life examples

Every person's circumstances are different, but the following examples illustrate situations where specialist advice can make a real difference.

Example 1 – Advanced dementia

Mrs A had advanced dementia and required constant supervision due to wandering, aggression, poor nutrition and a high risk of falls.

Her family had been paying care home fees for over two years because they believed dementia care was always means-tested.

Following a specialist review of her care records and a properly prepared assessment, she was found eligible for NHS Continuing Healthcare, removing the ongoing burden of care fees.

Example 2 – Complex care at home

Mr B suffered a severe stroke leaving him with swallowing difficulties, reduced mobility and significant communication problems.

His wife was providing most of his care with limited support.

After specialist representation during the assessment process, the NHS agreed to fund an extensive package of care at home, allowing him to remain in familiar surroundings while reducing the pressure on his family.

Example 3 – Funding previously refused

Mrs C had Parkinson's disease with frequent falls, cognitive impairment and complex medication requirements.

She had previously been assessed and found ineligible.

A detailed review of the decision identified several areas where the evidence had not been properly considered.

Following representations and a fresh assessment, funding was awarded.

Why specialist support matters

Although families are entitled to represent themselves, the assessment process is often far more complex than people expect.

The National Framework, Decision Support Tool and associated guidance require detailed knowledge of how healthcare needs should be assessed.

Specialist advisers understand:

• How eligibility decisions are made.
• What evidence is most persuasive.
• How care records should be analysed.
• Where assessments may have overlooked important information.
• How to challenge incorrect decisions.
• How to pursue retrospective claims where appropriate.

Having experienced support can help ensure that an individual's needs are properly understood and fairly assessed.

Why choose Gosschalks?

At Gosschalks, we understand that families often come to us during some of the most difficult periods of their lives.

Our NHS Continuing Healthcare specialists combine legal expertise with extensive knowledge of the CHC assessment process, allowing us to provide practical, compassionate and independent support from start to finish.

We can assist with:

• Initial eligibility advice.
• File and care record reviews.
• Preparing for assessments.
• Representation during assessments.
• Challenging funding decisions.
• Appeals.
• Retrospective claims where funding may have been wrongly refused.

Our aim is simple: to ensure every client receives a fair assessment based on the evidence and the law—not assumptions.

Don't assume you're not eligible

Many families discover NHS Continuing Healthcare only after they have spent substantial sums on care.

If you or someone you care for has significant healthcare needs, obtaining specialist advice early can help you understand your options and ensure that any entitlement to NHS funding is properly explored.

A conversation today could make a life-changing difference to the care your loved one receives—and to your family's financial future.

If you would like to discuss an assessment or appeal, our NHS Continuing Healthcare team at Gosschalks is here to help.

***Key contact: Stephanie Ford