New data obtained by Winston Solicitors through a Freedom of Information (FOI) request to NHS England has brought to light considerable disparities in NHS funding for Continuing Healthcare (CHC) across the 42 Integrated Care Boards (ICBs) in England. Despite the existence of a unified national eligibility framework for CHC, the figures demonstrate a vast regional variation in how this essential care is funded.

Continuing Healthcare (CHC) is a comprehensive care package fully funded by the NHS, designed for adults who have significant ongoing health needs. This funding can be applied to care provided in various settings, including a care home, a hospice, or even within the individual’s own home, ensuring that those with complex medical conditions do not incur personal out-of-pocket expenses for their care. Unlike social care, CHC is not subject to means-testing; however, its eligibility criteria are exceptionally strict, and the assessment process is often complex and challenging for families.

The FOI data revealed stark contrasts in spending, exemplified by NHS North East & North Cumbria ICB which allocated over £382 million to CHC in 2023/24. In sharp contrast, NHS Bedfordshire, Luton & Milton Keynes ICB spent a mere £86.4 million during the same period. Even when adjusting for population differences, North East & North Cumbria consistently allocated a significantly higher amount per capita compared to the Bedfordshire-based ICB.

An analysis of expenditures shows specific ICBs leading in CHC funding. The highest expenditures in millions of pounds were recorded by NHS North East & North Cumbria ICB (£382.7M), followed by NHS Cheshire And Merseyside ICB (£357.5M), NHS Lancashire & South Cumbria ICB (£303.3M), NHS North West London ICB (£258.2M), and NHS West Yorkshire ICB (£243.5M). Conversely, the ICBs with the lowest CHC expenditures included NHS Somerset ICB (£53.4M), NHS Cornwall & Isles Of Scilly ICB (£56.4M), NHS Lincolnshire ICB (£60.9M), NHS Gloucestershire ICB (£67.0M), and NHS Northamptonshire ICB (£81.1M).

Furthermore, the FOI request uncovered inconsistent application of the Fast Track pathway, a statutory route designed for patients nearing the end of life who require care arrangements within 48 hours. Disturbingly, several ICBs, including Bedfordshire, Luton & Milton Keynes, and Birmingham & Solihull, reported spending £0 on Fast Track CHC in 2023/24. This occurs despite a report from Age UK, 'Continuing to Care,' which indicated a national increase in Fast Track referrals as access to standard CHC became more difficult.

Integrated Care Boards were officially established in July 2022 under the conservative government. A comparison of half-year expenditures on CHC from 2022/23 with the full-year data for 2023/24 suggests an overall trend of decreasing CHC expenditures. While certain categories, such as Adult Personal Health Budgets (PHBs), saw localized growth, every ICB reduced its overall CHC spending. Overall CHC spending is estimated to have decreased by a significant 42% in 2023/24 compared to a full-year estimate for the preceding fiscal year.

James Urquhart-Burton, a representative from Winston Solicitors, commented on these findings, stating, “The data reveals striking regional disparities in CHC spending, with some ICBs allocating more than four times as much per year as others. These differences raise serious questions about equity and access to care. It’s more important than ever for individuals and families to have expert support when navigating this system, especially in areas where funding appears constrained.” These revelations underscore the critical need for scrutiny and potential reform to ensure equitable access to essential NHS Continuing Healthcare across all regions of England.