NHS Continuing Healthcare in Wales: How Funding Works for Complex Care

Continuing NHS Healthcare (CHC) can pay for a full package of care, at home, with no means testing. For people with complex health needs it is often the most valuable funding route there is, and it is also the most confusing part of the whole funding picture. Of all the questions families bring to a first conversation with us, this is the one that ties people in knots.

Here is a plain-language guide. One thing to fix in your head before we start: Wales has its own CHC framework, set by the Welsh Government and run by local health boards. If you have read guidance online, check that it is about Wales. England's rules and timescales are different. You can read the basics on NHS Wales Continuing Healthcare.

What CHC actually pays for

Continuing NHS Healthcare is a package of care arranged and funded entirely by the NHS, for adults whose need for care is primarily driven by their health. The test is whether someone has a "primary health need": broadly, whether the main reason they need support is a health condition rather than social care needs alone.

Two things follow that surprise many families. CHC is not means tested, so income and savings are irrelevant. And CHC can be delivered at home, not only in a nursing placement. Many of the packages we support across Wales are CHC-funded and delivered in people's own homes.

How the assessment works

The process runs in three stages. It starts with the Checklist, a screening tool completed by a health or social care professional that decides whether someone should go forward for a full assessment. You can ask for a Checklist to be done. If you think there is a case, raise it with your GP, social worker, community nurse or health board.

Next comes the full assessment. A multidisciplinary team looks at needs across areas such as mobility, cognition, behaviour, medication and breathing, using a Decision Support Tool to build a picture of the nature, intensity, complexity and unpredictability of need. The Welsh framework is clear that this should be person-centred: you and your family should be involved throughout, not informed afterwards.

Finally, the health board decides eligibility on the strength of that assessment. If someone is eligible, the NHS funds the package in full. If not, care may still be funded through other routes. These include joint packages where the health board and local authority share the cost, Direct Payments for Continuing NHS Healthcare, or a Personal Health Budget in some circumstances. The National Health Service (Direct Payments) (Wales) Regulations 2026 came into force on 25 March 2026, which set out how those direct payments work in Wales.

If you disagree with the decision

Decisions can be challenged, and successful challenges are not rare. In Wales the timescales are specific. You must normally tell the health board in writing, within 28 days of the decision, that you want it reviewed, and your decision letter will set out the exact process. So act promptly. Put your intention in writing early, even while you are still gathering your case. Keep copies of every assessment document, and ask for the Decision Support Tool record if you were not given it.

Where we fit in

We are a care provider, not a benefits adviser, but we work inside this system every week alongside families, social workers and health board teams. We can help you understand what stage you are at, what to ask for next, and what a funded package could actually look like at home. That includes employing someone you already trust as a PA. If you are starting from scratch, our guide to supporting complex needs at home is a good companion to this one.

And if you have already had an assessment, we are happy to talk through what a CHC-funded package could look like in practice, before any funding decision is finalised.

Talk it through with us. Book a free, no-obligation conversation via our contact form or on 0345 061 9000.