Does the abolishment of NHS England affect Continuing Healthcare?
Change at the top of the health service can feel unsettling, so we’ve compiled this short guide, which sets out in simple terms what the abolishment of NHS England means, what is changing and how this could affect NHS Continuing Healthcare (CHC).
In this article, we’ll explore:
What was the role of NHS England?
NHS England was the national body that led the NHS in England, setting priorities, overseeing commissioning and performance, managing large budgets and, after its merger with NHS Improvement, held provider oversight at a national level.
Although it operated at arm’s length from ministers, it worked closely with local systems such as Integrated Care Boards (ICBs) to plan and fund services across regions. In short, it handled national strategy and assurance while local bodies delivered day-to-day care.
What was NHS England’s role in Continuing Healthcare?
For NHS Continuing Healthcare (CHC), a non-means-tested package of fully funded care where a person’s primary need is a health need, NHS England focused on policy and oversight while ICBs made local decisions. NHS England would:
- Set policy and assurance against the National Framework for NHS Continuing Healthcare.
- Issue guidance on how local bodies should apply the Framework to CHC services.
- Maintain national oversight and escalation routes where needed.
- Leave day-to-day eligibility decisions with local ICBs, using the Checklist, MDT and DST assessment process.
What does the abolishment of NHS England mean?
On 13th March 2025, the Prime Minister announced the abolishment of NHS England, with its functions now being integrated into the Department of Health and Social Care (DHSC) over a transition period of up to two years. The stated aims include cutting bureaucracy and bringing management closer to ministers so that running costs can be reduced and more resources can be directed to frontline care across health and social care.
Structural changes to expect:
- National level: policy, strategy and parts of oversight move into DHSC as NHS England winds down during transition. Responsibilities that previously sat with the arm’s-length body are absorbed into the Department of Health.
- Local level: ICBs continue to plan, commission and make CHC eligibility decisions in their areas. Guidance to the service emphasises tighter financial grip and reinvestment locally with partners such as local authorities and adult social care teams.
These changes concern where national control and assurance sit, but do not remove existing legal entitlements to NHS care, including CHC.
How does the change affect Continuing Healthcare?
Your rights to CHC remain the same. The assessment process under the National Framework continues, and families should still expect a structured approach led locally by the ICB.
What to expect:
- ICBs remain your primary contact for CHC assessment and funding decisions. For more detailed insight on their responsibilities, read our blog ‘What is an ICB and its role in CHC funding?’
- The core process remains the same:
- Checklist screening
- Multidisciplinary Team (MDT) assessment using the DST
- ICB eligibility decision, with routes for review and appeal
- Timelines may fluctuate during the transition as teams and reporting lines change, so keep records up to date, respond to requests promptly and follow up in writing where necessary to keep your case moving.
- Appeals and reviews continue as usual. Escalation routes should remain available, although national contact points may change as DHSC integration progresses.
In short, the impact on CHC is operational rather than legal – processes remain unchanged, but there could be short-term disruption while these new structures bed in and responsibilities are redistributed nationally.
Benefits of abolishing NHS England
If delivered well, the reform aims to:
- Simplify national oversight and reduce duplication between bodies, making it clearer who is accountable for policy and performance.
- Improve local coordination between health and social care through ICBs and local authorities, which can support more joined-up planning for people with complex needs.
- Lower administrative costs at national level, allowing resources to be redirected into assessment capacity and frontline services.
- Provide a more person-centred, localised CHC experience if repeated hand-offs are reduced and decision-making is closer to patients.
Can you still apply for Continuing Healthcare?
Yes, you can still apply for NHS Continuing Healthcare and you can challenge past decisions. If your primary need is a health need, the NHS could fund 100% of your care. Farley Dwek’s nurse-led legal team can help you prepare for the Checklist, support you at the MDT and manage appeals where needed.
For further information about some of the topics covered in this article, take a look at ‘What is an ICB and its role in CHC funding?’ and ‘What is an MDT meeting?’.
To book a free initial discussion with Farley Dwek to talk through eligibility, the assessment process and appeals, or for further information about the abolishment of NHS England and what this means for you, get in touch with our team online or call 0161 272 5222.