Sharp rise in NHS Continuing Healthcare rejections prompts calls for government review

Nearly 30% more people are being denied NHS-funded care and support following reassessment despite no change to eligibility criteria, according to new research from The King’s Fund, which is calling for an urgent government review of the system.

Analysis by the think tank found that the number of recipients of Fast Track NHS Continuing Healthcare (CHC) packages found no longer to be eligible upon reassessment increased by 28.21% between the first quarter of 2017/18 and the fourth quarter of 2025/26.

Fast Track CHC provides NHS-funded health and social care support for people with a rapidly deteriorating condition who may be entering a terminal phase of illness. Because CHC covers the full cost of eligible individuals’ health and social care needs, losing access to the support can have major financial consequences for patients and their families.

The research also found a substantial fall in the proportion of applicants assessed as eligible for Standard CHC. In April to June 2017, 31.25% of applicants were deemed eligible, compared with 16.65% between January and March 2026. The findings represent a decline from almost one in three applicants receiving support to fewer than one in five.

The King’s Fund said the trend raises concerns because the criteria used to determine eligibility have remained unchanged throughout the period examined.

Katie Purbrick-Thompson and Niamh Buckingham, co-authors of the report and Policy Advisers at The King’s Fund, said: "The drop in CHC eligibility despite no change in the criteria is deeply concerning. It raises questions as to why this is happening and the government should launch a full review into CHC to fully understand this deterioration in eligibility rates."

The report also highlights significant geographical variation in access to CHC funding. In January to March 2026, 35.37% of people assessed for Standard CHC in Cambridge and Peterborough Integrated Care Board (ICB) area were found eligible, compared with just 2.26% in Gloucestershire.

Purbrick-Thompson and Buckingham said: "Whether it be funding pressures making ICBs more reluctant to put in place support or because of the complex and different structures that the NHS and social care operate within, people who have seen their eligibility revoked, especially those at the end of their life, deserve answers as to why this is happening and why there is such geographical variation."

The findings are published as part of The King’s Fund report, ‘No man’s land’: the experience of patients at the interface between health and social care, which examines how people navigate the boundaries between NHS and social care services.

The report argues that inconsistent decision-making around CHC is symptomatic of wider problems in the relationship between health and social care systems.

Purbrick-Thompson and Buckingham said: "This is just one example of the interaction between NHS and the social care system being broken. A lot of the time, the right hand does not know what the left is doing and it leads to people falling through the cracks and suffering as a result."

Among its recommendations, the report calls for a review of declining CHC eligibility rates and rising reassessments, stronger national oversight of the framework, more consistent application of eligibility criteria, and improvements to communication with patients and families.

The report also argues for a more fundamental reform of social care funding, including widening eligibility for publicly funded social care in order to reduce reliance on complex decisions about whether responsibility for care sits with the NHS or local authorities.

Purbrick-Thompson and Buckingham said: "As we set out in our report, there is only so far tinkering around the edges will go. If we want a joined-up health and care system that improves both the NHS's performance and people's quality of life, expanding eligibility to publicly funded social care is fundamental.

"It would reduce reliance on these complex boundary decisions like CHC and give a clear line of accountability for who is responsible for this patient’s care. We strongly urge the Casey Commission to pick up this mantle and recommend a widening of social care support in its final report."

The report has been supported by contributions from the Social Care Institute for Excellence (SCIE), which said longstanding efforts to improve integration between health and social care have failed to deliver consistent results.

Gerard Crofton-Martin, Interim Chief Executive at SCIE, said: "The ‘no man’s land’ that exists between health and social care because of support delays, confusion, and service fragmentation leaves too many people without the care and support they need to live well and independently."

He added: "The Government has repeatedly sought to address this through legislation. As this report makes clear, however, success has been limited. We know that ambitions have been unevenly realised, with persistent differences in people’s access to services, their experiences of those services, and the outcomes they achieve."

Crofton-Martin said improving navigation between services must become a priority and argued that stronger community-based support is needed to prevent needs escalating and to sustain people’s health and wellbeing.

He added: "With demand for care continuing to rise and more people forced to self-fund their care because they don’t qualify for local authority support, the need for a national conversation on the future of social care has never been greater. The Casey Commission offers an opportunity to build an evidence base for a system that is fairer, more sustainable, and better able to support everyone, regardless of who they are and where they live, to lead fulfilling lives."