What is continuing healthcare?

Continuing healthcare is a package of care arranged and funded by the national health service (NHS) in England, for a person aged 18 or over, to meet physical or mental health needs which are the result of disability, accident or illness. Continuing healthcare is provided to people who have a ‘primary health need’ and need help that cannot be provided by a local authority alone as part of a social care package.

Local authorities can’t provide support for health-related needs unless they are only a small part of your overall needs. Your care might be provided purely by the NHS as continuing healthcare, or as part of a joint package between NHS continuing healthcare and social care. The organisation that is responsible for providing your care will depend on what type of needs you have.

For an overview of continuing healthcare, you might like to watch the below video made by NHS England, read the leaflet created by the Department of Health and Social Care, or have a look at the national framework:

For more information on how we apply the National Framework in North East Lincolnshire, please see our Continuing Health Care Overarching Policy.

What is a Primary Health Need?

‘Primary health need’ is a concept developed by the government to help decide if a person’s primary need is for healthcare (which should be provided by the NHS) rather than for social care (which may be provided by the council). You have a ‘primary health need’ if most of the help you need is to address existing health needs, or to prevent other health needs from starting or from getting any worse.    

When deciding whether you have a primary health need, your assessor will look at your needs by thinking about each of the following:

  • The nature of your needs: this means the characteristics, qualities or features of your needs, and the type of needs. Your needs might be physical, mental or psychological. It also means thinking about the effect and impact of those needs on you, and the type of help you might need to manage them.
  • The intensity of your needs: this means both the extent or amount of your needs, and the severity or degree of your needs. It also means thinking about the help you need, including the need for sustained or ongoing care.
  • The complexity of your needs: this means how your needs present and interact with each other, in a way that could increase the skills needed to help you. Complex needs might require a higher level of skill to monitor, treat or manage. Needs can be complex when you have more than one condition or because of the interaction between conditions. But needs can also be complex when you have a single condition. Your response to your condition can also have an impact on your needs, for example where a physical health need results in you developing a mental health need.
  • The unpredictability of your needs: this means the amount that your needs change or fluctuate (get better or worse). The amount that your needs fluctuate can make them more difficult to manage, and can mean that you are at greater risk if you don’t get the right care at the right time. If you have an unpredictable healthcare need, you are likely to have a fluctuating or unstable condition, or one that is quickly getting worse.

If you want to read more about each of these things, you can read more in the National framework for NHS continuing healthcare and NHS funded nursing care.

The reasons given for deciding whether you have a primary health need should not be based on:

  • your diagnosis
  • where you might receive care and support
  • the ability of your care provider to manage your care
  • whether or not NHS-employed staff can be used to provide your care
  • whether or not you need specialist staff to provide your care
  • the fact that a need is well-managed
  • the existence of other NHS-funded care; or
  • your ability or willingness to pay for or contribute to a package of care (continuing healthcare is free to those who are eligible)

A decision should be based on what you need, which might be different from what you would like.

Page last updated: 06 Oct 2023