Thousands of vulnerable people across England may be missing out on fully-funded NHS care they're entitled to, according to new research revealing a stark "postcode lottery" in healthcare funding. The Nuffield Trust analysis shows some areas spend nearly three times more per person on NHS Continuing Healthcare than others – raising serious questions about fairness in our health system.
NHS Continuing Healthcare (CHC) is a crucial lifeline for people with complex health needs. This fully-funded care package covers everything from nursing support to accommodation costs for those whose primary need stems from illness, disability or accident. Unlike social care, there's no means test – if you qualify, the NHS pays the full cost, whether you receive care at home or in a residential setting.
The Trust's report, 'Falling through the gaps? A closer look at NHS continuing health care', examined spending patterns across England's Integrated Care Boards – the local NHS bodies responsible for healthcare planning. What they found was troubling: dramatic variations in funding per person aged 65 and over, suggesting some areas may be applying eligibility criteria more strictly than others.
For families already dealing with complex health conditions, these inconsistencies can be devastating. Those unlucky enough to live in lower-spending areas may find themselves wrongly denied funding, forcing them to pay thousands in care costs from their own pockets or go without essential support. Given that CHC can cost £50,000 or more annually, these decisions can quickly bankrupt families or leave vulnerable people without proper care.
The NHS has clear national guidelines for CHC eligibility, yet this research suggests they're being interpreted very differently across England. The Trust rightly calls for urgent action to standardise assessments and ensure everyone receives the care they're legally entitled to, regardless of where they happen to live. In a health service founded on the principle of care free at the point of need, such variations are simply unacceptable.