Many families are surprised to discover that the NHS can contribute significantly to care home costs, and in some cases, cover them entirely. Two types of NHS funding are available to people in residential or nursing care: NHS-Funded Nursing Care (FNC) and NHS Continuing Healthcare (CHC). Both are widely misunderstood and, in many cases, not claimed at all.
This guide explains exactly how each type of NHS funding works, who qualifies, how the assessment process works, and how these payments interact with other sources of care funding. If a loved one is moving into a nursing care home, or is already resident in one, this information could make a meaningful difference to the cost of care.
At Merling Care, our teams at Glebe House in Staines and Moorland House in Barton-on-Sea are experienced in supporting families through funding assessments and can help connect you with the right contacts.
NHS-Funded Nursing Care (FNC) is a weekly payment made by the NHS directly to a registered nursing care home, to contribute towards the cost of nursing care delivered by a registered nurse. It is not means-tested, so it is available to both self-funders and local authority-funded residents alike.
FNC is only available to people living in a care home that is registered to provide nursing care, not a residential-only care home. It covers the nursing element of a person’s care package specifically, meaning the clinical input of a registered nurse, rather than the total cost of accommodation and personal care.
From 1 April 2026, the standard FNC rate in England is £267.68 per week, paid directly to the care home. If you moved into a nursing home before 1 October 2007 and were placed on the legacy “high band” at that time, the rate is £368.24 per week. The high band rate is no longer available to new entrants; only those already receiving it retain it.
Glebe House is registered for nursing, meaning eligible residents can receive FNC as part of their care funding package.
NHS Continuing Healthcare (CHC) is a package of care arranged and funded entirely by the NHS for people whose primary need is a health need. It covers the full cost of care, including accommodation and food in a care home, with no financial contribution required from the individual.
CHC is one of the most significant and frequently unclaimed forms of care funding available. Eligibility is not based on a specific diagnosis, and it is not means-tested. The sole criterion is whether the main aspect, or the majority part, of a person’s care needs is focused on addressing or preventing a health need.
Where CHC is awarded, it replaces both local authority funding and any personal contribution the individual has been making. Even self-funders who have been paying significant care costs can be awarded CHC retrospectively in some circumstances.
CHC can be delivered in a care home, a nursing home, a hospice, or in the person’s own home. The setting is determined by the individual’s assessed needs and personal preferences.
These are two distinct forms of NHS funding that are often confused. The key differences are:
NHS-Funded Nursing Care (FNC)
NHS Continuing Healthcare (CHC)
A person cannot receive both CHC and FNC simultaneously. If CHC is awarded, it covers everything. FNC applies when someone needs nursing care but does not meet the higher threshold for CHC.
FNC eligibility applies to adults who:
The assessment for FNC is relatively straightforward. A registered nurse, typically working for the local ICB or the care home, will carry out a clinical assessment to determine whether the person requires nursing input. The outcome is a binary decision: FNC is either awarded at the standard rate, or it is not.
Because FNC is not means-tested, it applies equally to self-funders and those receiving local authority support. For self-funders, the weekly payment of £267.68 is made by the NHS directly to the nursing home, reducing the effective cost of care by that amount each week.
CHC eligibility is determined by the nature, complexity, intensity, and unpredictability of a person’s health needs, not by their diagnosis alone. The National Framework for NHS Continuing Healthcare (last revised July 2022) sets out the principles and processes that ICBs must follow.
Eligibility for CHC is assessed across 12 care domains:
Each domain is assessed and scored across levels ranging from no need through to priority. The scoring produces a profile that the multidisciplinary team (MDT) uses to determine eligibility. In broad terms, a priority-level need in any single domain, or severe-level needs across multiple domains, is likely to indicate eligibility for CHC. However, the overall interaction and intensity of needs across all domains is what ultimately guides the decision.
CHC is not a benefit and it is not rationed by budget. If a person is assessed as eligible, the NHS has a legal duty to fund their care in full. This is why a properly conducted assessment matters so much. If you believe a loved one’s needs are primarily health-related, it is always worth requesting an assessment.
The CHC assessment follows a structured, multi-stage process overseen by the relevant Integrated Care Board (ICB).
Stage 1: The CHC Checklist The process begins with a screening checklist, completed by a qualified health or social care professional. This tool is deliberately set at a low threshold to ensure that anyone who may be eligible proceeds to a full assessment. A positive checklist does not confirm eligibility; it simply triggers the next stage.
Stage 2: The Decision Support Tool (DST) If the checklist is positive, a full multidisciplinary assessment is carried out using the Decision Support Tool (DST). The DST is completed by a team including health and social care professionals who know the person’s needs. It evaluates all 12 care domains in detail.
Stage 3: The Eligibility Decision The ICB makes the final eligibility decision, normally within 28 calendar days of the positive checklist. The individual, their family, and any advocates are entitled to be involved in the process and to receive a written explanation of the outcome.
Fast Track CHC: Where a person has a rapidly deteriorating condition and may be approaching the end of their life, a Fast Track assessment can be requested. This can result in CHC being awarded within 48 hours, without waiting for the full DST process.
The Fast Track Tool is designed specifically for palliative situations. It is available through the GP, a hospital consultant, or the care home’s nursing team.
NHS funding and local authority funding are separate systems that can interact in different ways:
If a person’s circumstances change after a local authority funding arrangement is in place — for example, if their health needs increase significantly — a fresh CHC assessment can be requested at any time.
You can read more about how local authority means testing and self-funding work in our companion guide: Who Pays for Care Homes? Funding and Local Authority Support Explained.
The following rates apply from 1 April 2026 in England:
NHS-Funded Nursing Care (FNC)
These rates are confirmed in Age UK Factsheet 20 (NHS Continuing Healthcare and NHS-Funded Nursing Care), updated for April 2026. They are reviewed annually by NHS England.
NHS Continuing Healthcare (CHC) CHC has no fixed weekly rate. It covers the full, agreed cost of an individual’s care package, which is negotiated between the ICB and the care provider. There is no upper limit.
For people receiving palliative care in a nursing or care home, NHS funding can be particularly relevant. Two routes are especially common:
Families dealing with a palliative diagnosis should always ask whether a CHC assessment, or a Fast Track referral, has been considered. It is one of the most impactful questions to ask.
To understand more about palliative care at Merling Care and the support we offer to families at every stage, read our guide: Understanding the 5 Stages of Palliative Care.
At Merling Care, we work closely with GPs, district nurses, and Integrated Care Boards (ICBs) to ensure that residents who may be eligible for NHS funding are identified and assessed appropriately. We believe every resident should receive every penny of funding they are entitled to.
Our team at Glebe House, which is registered for nursing, is experienced in supporting FNC and CHC assessments and liaising with local ICBs on behalf of residents and their families. Moorland House works closely with community nursing teams for residents whose needs develop over time.
We also hold CQC ratings of Good at both homes, reflecting the quality and consistency of care our residents receive.
If you would like to discuss NHS funding options, or to arrange a visit to either home, please get in touch:
Or contact us online to arrange a visit.
No. NHS Continuing Healthcare is not means-tested. Eligibility is based entirely on whether a person’s primary need is a health need, not on their income, savings, or property.
Yes, in principle. CHC can be delivered in any setting, including a residential care home without nursing registration. However, in practice, CHC is most commonly provided in nursing homes, hospices, or in the person’s own home, because the level of care needs required to qualify typically requires nursing input.
CHC is subject to regular review. If a person’s health needs reduce below the primary health need threshold, CHC may be withdrawn and funding responsibility may revert to the individual or the local authority. Reviews should be conducted at least annually and whenever there is a significant change in needs.
Yes. Any adult can request a CHC screening assessment. You should contact the relevant ICB or ask your GP, hospital consultant, social worker, or the care home’s nursing team to initiate the process. A professional referral is not strictly required.
A standard CHC assessment should be completed within 28 calendar days of a positive checklist. Fast Track assessments are designed to be completed much more quickly, typically within 48 hours, for people in rapidly deteriorating or end-of-life situations.
A refusal of CHC does not end the assessment process. If a person has been assessed as requiring nursing care, they should automatically be considered for NHS-Funded Nursing Care (FNC), which is paid at £267.68 per week from April 2026. You can appeal a CHC refusal through the local ICB.