Understanding Care Funding
CHC, NHS-Funded Nursing Care, and Social Care \u2014 What\u2019s the Difference?
Three different funding streams cover care for older and disabled adults in England \u2014 and the difference between them is worth tens of thousands of pounds a year. Here\u2019s a plain-English guide to what each one covers, who pays, and how they interact.
Last reviewed June 2026 · Based on the National Framework for NHS Continuing Healthcare (revised 2022).
The three funding streams
Care in England is funded through a fragmented system that most families encounter in crisis, without warning. The three main streams are:
NHS Continuing Healthcare (CHC) \u2014 full NHS funding for people whose primary need is a health need. The NHS pays all care costs. No means test. No contribution from savings or assets. Available to people who meet the primary health need threshold assessed across 12 care domains.
NHS-Funded Nursing Care (FNC) \u2014 a flat weekly contribution from the NHS toward registered nursing costs in a nursing home. Currently \u00A3235.88 per week in 2024/25 (reviewed annually). Available to people in nursing homes who do not qualify for CHC but have registered nurse care needs. It is not a means-tested payment \u2014 it is a contribution to the nursing element of the fee.
Social care funding \u2014 means-tested funding from the local authority for care when needs are primarily social rather than health. Capital above \u00A323,250 means the person pays in full. Between \u00A314,250 and \u00A323,250, the person makes a sliding-scale contribution. Below \u00A314,250, the local authority funds in full.
The financial difference between CHC (fully funded) and social care (means-tested) is typically \u00A340,000\u2013\u00A370,000 per year for a person with significant assets.
Comparison at a glance
| CHC | FNC | Social Care | |
|---|---|---|---|
| Who pays | NHS in full | NHS (contribution only) | Local authority (means-tested) |
| Means tested | No | No | Yes |
| Amount | All care costs | £235.88/week (2024/25) | Up to full cost below £23,250 capital |
| Who qualifies | Primary health need (12-domain assessment) | Nursing home residents with registered nurse needs who don’t qualify for CHC | People with eligible social care needs and capital below £23,250 |
| Where care is delivered | Care home, nursing home, or at home | Nursing homes only | Care home, nursing home, or at home |
| How to access | Request CHC assessment from GP, social worker, or ICB | Automatic once CHC ineligible in nursing home | Social care needs assessment from local authority |
The boundary problem
The line between health and social care is the central dispute in CHC. The NHS has a financial interest in classifying needs as social. Local authorities have the same interest in classifying them as health. Families caught in the middle often receive conflicting advice and end up paying privately while the two systems point at each other.
The law \u2014 established in R v North and East Devon Health Authority, ex parte Coughlan[1999] \u2014 is clear: where needs are primarily a health responsibility, the NHS must fund them. The difficulty is that “primarily a health responsibility” is interpreted inconsistently across England's 42 ICBs.
The practical consequence is that families with loved ones whose needs sit near the boundary \u2014 significant health needs combined with substantial social care needs \u2014 are frequently refused CHC inappropriately and pushed toward self-funding.
What to do if you think the wrong funding stream has been applied
If your loved one is currently self-funding and has significant health needs, request a CHC assessment. Do not assume the local authority's assessment reflects what the NHS owes.
If your loved one is receiving FNC but you believe their needs meet the CHC threshold, request a full CHC assessment. FNC is not a consolation prize \u2014 it is a separate, lower tier that should not substitute for CHC where CHC is appropriate.
If your loved one has been told their needs are “social” without a CHC screening having been completed, challenge this in writing. The NHS is required to screen for CHC eligibility before concluding that needs are social.
Frequently asked questions
Can someone receive both CHC and FNC at the same time?
No. CHC and FNC are mutually exclusive. FNC is available to people who do not qualify for CHC but are in a nursing home with registered nurse needs. Once someone qualifies for CHC, their care costs are covered in full by the NHS and FNC no longer applies separately.
If someone is self-funding in a care home, can they still get CHC?
Yes. The type of care home and the current funding arrangement do not determine CHC eligibility. If a person’s needs meet the primary health need threshold, they qualify for CHC regardless of whether they are currently self-funding, receiving local authority funding, or receiving FNC.
Does the FNC rate cover the full nursing cost in a nursing home?
Rarely. The FNC rate (£235.88/week in 2024/25) is a contribution toward the cost of registered nurse input — it does not cover the full nursing element of a nursing home fee, which is typically higher. The remainder is paid by the person or the local authority, depending on the means test.