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Investigation into NHS continuing healthcare funding


NHS continuing healthcare funding (CHC) is a package of care provided outside of hospital that is arranged and funded solely by the NHS for those 18 or older who have significant ongoing healthcare needs. In 2015-16, almost 160,000 people received, or were assessed as eligible for, CHC funding in the year, at a cost of £3.1 billion. If someone is assessed as not eligible for CHC funding, they may still be entitled to other health and social care services, some of which the individual may have to pay for.

The National Audit Office (NAO) published an investigation into CHC in July, in which the NAO identified problems with the CHC assessment process as the current process both raises people’s expectations over whether they will receive funding, as well as failing to make the best use of assessment staff. It was also found that while in most cases eligibility decisions should be made within 28 days, often people are waiting longer. Delays in the eligibility process are of concern as they can cause both emotional distress to patients as well as financial pressures. The number of people receiving CHC funding is rising and as such, the funding is causing considerable pressure on Clinical Commissioning Groups (CCGs). The NAO investigation also found that there is significant variation between CCGs in both the number and proportion of people assessed as eligible for CHC; this may be due to differences in the way CCGs are interpreting the national framework to assess whether people are eligible for CHC, due to its complexity.

The Public Accounts Committee will consider developments made on CHC since July and question representatives from the Department of Health and NHS England to ask them what is being done to improve the assessment process and how NHS England’s efficiency plan is affecting the spending of CCGs and the delivery of CHC. The Committee will also hear from representatives from the Continuing Healthcare Alliance, the Spinal Injuries Association, Sue Ryder and the CHC advocacy group Beacon.