Acceptances for Fast Track NHS Continuing Healthcare down a third over eight years despite no change in criteria, research finds

The packages provide NHS-funded health and social care support to people with a rapidly deteriorating condition which may be entering a terminal phase.

More than 50,000 people in England are eligible for CHC across its Standard and Fast Track streams, the King’s Fund said, with NHS expenditure on these services being around £6.5bn annually.

King's Fund research found the number of recipients deemed no longer eligible on reassessment increased by 28.21% between the first quarter of 2017/18 - earliest data available - and the last quarter of 2025/26 Q4, the most recent.

It also found that the proportion of applicants for Standard CHC - as opposed to the fast track - assessed as eligible in April-June 2017 was 31.25% but only 16.65% in January-March 2026.

Any removal or rejection of support can have major financial implications for individuals and their families, the King’s Fund warned, as applicants could be pushed into the means-tested social care system leaving them without funding for high care costs.

Researchers also found significant regional disparities in eligibility rates, ranging from 35.37% found eligible in Cambridge and Peterborough to only 2.26% in Gloucestershire.

The King’s Fund called for a review into the decline in CHC eligibility “with a particular focus on reducing unwarranted variation between areas” and for stronger national oversight and more consistent application of the CHC framework to help ensure fairer access.

Report co-authors Katie Purbrick-Thompson and Niamh Buckingham 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.”

They added: “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.

“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.”

Mark Smulian