Developing insights on Continuing Health Care (CHC) and Continuing Care funding and processes



  • In 2023,Transformation Nous (TN) was commissioned by the Director of Adult Social Care of a local Council to conduct a detailed bottom-up diagnostic regarding Continuing Health Care (CHC) funding for adults, and Continuing Care funding for children and young people (CYP).
  • CHC is a package of care for adults with particularly intense, complex, or unpredictable primary care needs, which is arranged and funded solely by the NHS to cover all of the individual’s associated care costs (health and social care) – see Figure 1 for an overview of the process by the standard and fast track referral pathways. Continuing care is an additional NHS-funded health package for CYP with complex health care needs which cannot be met by existing universal or specialist services.
  • The specific deliverables of the programme were to:
  • Understand how spend by health and social providers changed over time
  • Identify conversion rate and local resolution request / appeal rate of health funding for adults (CHC) & children (Continuing Care) and how rates changed over time
  • Benchmark spend and access to CHC funding with other places
  • Map the current process for allocating health funding to adults and children, how it varies in practice and understanding of the process by system partners
  • Develop recommendations for the local system to change its approach / process to improve accessibility to the right funding, at the right time for residents


Key findings


The local place is now embarking on an ICB-wide transformation project to support a system reset to address challenges that have intensified since onset of Covid and to collectively move toward more consistent, collaborative ways of working (see Figure 4A). Key recommendations developed during the programme (see Figure 4B) included:

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