Number of People Successfully Claiming NHS CHC Funding Drops by a Third, NHS Figures Show

Latest NHS England figures reveal that the number of adults receiving completed NHS Continuing Healthcare (CHC) assessments, and the proportion that are deemed eligible for the funding package, has yet to recover to pre-pandemic levels, according to analysis from retirement specialist Just Group.

CHC is an NHS-provided package that fully funds people’s care where there is primarily a ‘health need’. This means that qualifying treatment or care is typically for serious, long-term or complex conditions which may have arisen from a disability, accident or illness which affects the individual’s day-to-day care needs. NHS CHC is not means-tested and is available to people regardless of their wealth or assets.

In absolute terms, the number of people being assessed as eligible for CHC funding each year has dropped by 32% from 15,963 people in 2018/19 to 10,847 people in 2022/23.

In line with the declining number of successful claims, the number of CHC referrals has also slowed, with the quarterly average for the most recent full year (2022/23) standing at 15,630- 15% lower than that seen in 2018/19 (18,369).

Likewise, the quarterly average for the number of completed assessments remains stuck below pre-pandemic highs, with the 12,163 average for 2022/23 marking a significant 24% drop from the average for 2018/19 (16,045).

This downward trend in the number of new referrals and assessments completed has continued into the first quarter of this year, with 16,483 new CHC referrals and 12,906 completed assessments from April to June 2023, 13% and 23% respectively lower than the same quarter (Q1) in 2018/19.

There is a three-step process in CHC funding assessment process. The first step is to obtain a referral for on assessment, this is usually done by a qualified healthcare professional. The second step is for the assessment to be completed. Only once the assessment has been completed comes the third and final step- a decision on whether the individual is considered eligible for CHC or not. Over the past five years, there has been a general slowdown in the numbers across all these three steps.

Separate research from Just Group2 shows that more than three-quarters of over 45s (77%) have never heard of NHS CHC, whilst a further 14% have heard of CHC but don’t know any of the details.

Stephen Lowe, group communications director at retirement specialist Just Group, commented:

“Whilst the people completing the CHC process and being deemed eligible may be an increasingly rare group, it remains one of the most financially generous benefits on offer- helping patients in full with the financial costs associated with serious, complex and long-term medical conditions.”

“People who remain in the dark about the potential impact of CHC could not only face the vast costs associated with chronic health conditions but knock-on consequences such as deteriorating mental health or financial pressure on their loved ones.

“It is worrying that referrals and eligibility rates continue to lag below pre-pandemic levels sugge sting we are going backwards when it comes to raising awarenes s of CHC and supporting those in need with their applications.”

“We would strongly encourage those who believe that either a loved-one or themselves may qualify for CHC funding to speak to a qualified healthcare professional, whether that’s a GP, core home or district nurse or a social worker .They can help initiate the journey to potentially receiving this funding by filling in a checklist and offering further information on CHC and what can be expected throughout the application process.”