Comparison · Care Funding · 2026
NHS Continuing Healthcare vs Social Care Funding 2026: Who Pays for Care?
Understanding whether care costs will be covered by the NHS or by a means-tested local authority scheme can make a huge financial difference for families arranging care for an elderly or disabled relative. NHS Continuing Healthcare is fully funded regardless of wealth, but has a high eligibility bar; local authority social care funding is more widely available but assesses your income and savings. Here is how they compare in 2026.
TL;DR - 30-Second Summary
- - NHS Continuing Healthcare: fully funded, not means-tested, but requires a “primary health need” assessment with a high threshold
- - Local authority social care: means-tested against income and savings, more widely accessible but often requires a financial contribution
- - Always get assessed for CHC first: it is free care if eligible, so it should be ruled out before relying on means-tested funding
Side by Side: NHS CHC vs Social Care Funding
| Feature | NHS Continuing Healthcare | Local Authority Social Care |
|---|---|---|
| Means-tested | No — based purely on health need | Yes — based on income, savings, capital |
| Who funds it | NHS (Integrated Care Board) | Local council, with individual contribution if above threshold |
| Eligibility test | “Primary health need” via Checklist + Decision Support Tool | Care needs assessment + financial assessment |
| Settings covered | Care home, own home, hospice | Care home, home care, day care |
| Review frequency | Around 3 months, then typically annually | Periodic reassessment of needs and finances |
| Right to appeal | Yes — local resolution + independent review panel | Yes — local authority complaints/appeals process |
What Is NHS Continuing Healthcare?
NHS Continuing Healthcare (CHC) is a package of care fully funded by the NHS for adults with ongoing health needs that are primarily healthcare in nature rather than social care in nature. It is not means-tested — a person with substantial savings and a person with none are assessed on exactly the same health-needs basis. Assessment typically begins with a CHC Checklist screening tool, and if this suggests possible eligibility, a full multidisciplinary assessment follows using the National Framework Decision Support Tool, scoring needs across 12 domains including behaviour, breathing, mobility, nutrition, continence and skin integrity.
The bar for full CHC eligibility is intentionally high, reflecting a “primary health need” — most people with ongoing care needs, even significant ones, do not qualify and are instead assessed under means-tested local authority social care.
What Is Local Authority Social Care Funding?
If someone is not eligible for NHS Continuing Healthcare, their care needs are usually assessed by their local council under adult social care rules. This involves a care needs assessment (to determine what support is required) and, separately, a financial assessment (means test) looking at income, savings and — depending on the type of care and specific disregards that apply — property value. Depending on where the individual's finances sit relative to national capital thresholds, the council may fund care in full, in part, or not at all, with the individual expected to self-fund above the upper threshold.
Why Getting a CHC Assessment Matters
Because NHS CHC funding is not means-tested, it can save a self-funding family very substantial care home or home care costs if the person qualifies. Families are often not proactively offered a full CHC assessment, so it is worth explicitly requesting a CHC Checklist assessment (via the hospital discharge team, GP, or local Integrated Care Board) whenever significant ongoing health needs are present — before assuming that means-tested local authority funding, or full self-funding, is the only option.
NHS-funded nursing care (FNC) is a related but smaller fixed weekly payment toward nursing costs in a care home for people who need registered nursing care but do not meet the full CHC threshold — it is worth checking eligibility for FNC even where full CHC is refused.