Funding options for Brain in Hand: Care Act vs NHS Continuing Healthcare (CHC)

Area 

Care Act 2014 

NHS Continuing Healthcare (CHC) 

Legal basis 

Care Act 2014 (social care law) 

National Framework for NHS Continuing Healthcare 

Responsible body 

Local Authority 

NHS Integrated Care Board (ICB) 

Who it’s for 

Adults with care and support needs affecting daily living 

Adults with a primary health need 

Focus of assessment 

Impact on function and wellbeing 

Nature, intensity, complexity, and unpredictability of health needs 

Diagnosis alone 

Not relevant on its own 

Not relevant on its own 

Key question 

“Can the person achieve daily living outcomes and maintain wellbeing?” 

“Is the primary need a health need?” 

Eligibility threshold 

Lower, broader 

Higher, narrower 

Typical needs covered 

Personal care, daily living support, assistive technology, housing adaptations 

Complex nursing care, ongoing clinical supervision, unstable or intensive medical needs 

Mental health / cognition 

Eligible if it affects daily living and wellbeing 

Only if needs are complex, intense, or clinically unstable 

Assistive technology 

Commonly funded 

Rarely funded unless replacing clinical care 

Prevention duty 

Explicit legal duty 

Not a core principle 

Independence focus 

Central aim 

Secondary consideration 

Cost considerations 

Proportionate and reasonable 

Cost should not influence eligibility 

Charging 

Means-tested (except some services) 

Free at point of delivery 

Outcomes-based 

Yes 

No (needs-based)