Abstract

Continuing Health Care (CHC) is a package of care provided outside the hospital and funded by the National Health Service (NHS) for individuals with significant health needs. It is unique to the British system and is only provided when a significant health need has been identified. It amounts to providing care free of charge for chronically ill patients in their own home or in a care home with all expenses covered by the NHS. However, the primary needs of the patients need to be sufficiently high for them to be eligible for such care. It depends on the complexity of the individual’s needs and the intensity and unpredictability of their illness. The number of recipients of NHS Continuing Health Care has increased steadily over the last few years. According to the National Audit Office, the number of people assessed as eligible for CHC funding has grown on average by 6.4% a year over the last four years. In 2015–16, almost 160,000 people received or were assessed as eligible for CHC funding, at a cost of £3.1 billion (National Audit Office 2017). The NHS has nevertheless been criticised for the way it allocates continuing health care. The unevenness of allocation across regions and sub-regions is a cause for concern. This article thus attempts to establish why such disparities exist across localities. It does so by studying data made available by NHS England on CHC allocations, testimonials available on health care websites, and through semi-structured interviews with Clinical Commissioning Groups (CCGs) (local public providers of health care).