Complex care at home: What it is and who qualifies

• Complex care supports people with significant and ongoing healthcare needs, often due to chronic illness, disability, or recovery from serious injury.
• Eligibility for NHS-funded continuing healthcare (CHC) depends on whether a person’s primary need is a health need, assessed through a structured process by Clinical Commissioning Groups (CCGs).
• If NHS-funded support is not granted, local authorities may provide means-tested social care, or families can use personal health budgets or self-funding options.
• Hometouch offers tailored complex care at home, working with families, case managers, and health professionals to deliver skilled, safe, and consistent 24-hour support.

People who receive complex care live with substantial, ongoing health needs. These may arise from long-term disabilities, chronic illnesses, neurological conditions, or injuries requiring daily specialist support. Complex care is sometimes referred to as long-term care or continuing care. It can be delivered in various settings, most commonly in a person’s own home.

This type of care may support people living with:

• Spinal injuries
• Acquired brain injuries
• Neurological conditions
• Airway management needs
• Mental health conditions
• Learning disabilities
• Severe mobility limitations

At Hometouch, complex care is delivered in familiar surroundings. Each person receives a custom care plan shaped around their clinical, emotional, and daily living needs.

Complex care services are typically arranged or funded by the NHS and Clinical Commissioning Groups (CCGs) or local authorities. 

NHS and Clinical Commissioning Groups (CCGs)

CCGs may provide or fund complex care when health needs meet specific criteria. Support can be delivered in the individual’s home through NHS teams or approved care partners, in an NHS-funded nursing home, or in specialist third-party facilities where the NHS covers costs. However, not everyone with a disability or long-term condition is eligible for NHS complex care.

Local authorities

If an individual is not eligible for NHS continuing healthcare, their local council may arrange care following a means-tested assessment. Councils can charge for services they provide, depending on the person’s financial situation.

Who is eligible for NHS-funded complex care?

Eligibility for NHS continuing healthcare (CHC) is determined by CCGs. An individual may qualify when their primary need for care is a health need. Their condition must require ongoing, significant clinical support.

A complex medical condition requiring comprehensive interventions is more likely to meet the threshold for NHS-funded care.

What happens if NHS-funded care is not available?

If someone is assessed as ineligible for CHC funding, support may still be available through local authority social care budgets (means-tested), personal health budgets, or self-funding arrangements.

Local authorities may cover some or all of the cost, depending on income, savings, and assets.

What happens in the complex care assessment process?

Whether or not someone ultimately receives NHS funding, a care needs assessment identifies how best to support them. This involves evaluating health conditions, daily living needs, safety risks, quality of life, and medical complexity.

The assessment focuses entirely on the nature of the individual’s needs, not on where care will be delivered or who provides it.

The process often includes:

• Initial screening – a short checklist to determine if a full assessment is necessary
• Full CHC assessment – conducted by a multidisciplinary team (MDT)
• Fast-track assessment – used when someone is nearing the end of life, and urgent care is required

A screening or assessment does not guarantee that NHS funding will be approved.

People in England and Wales may be eligible for NHS Continuing Healthcare (CHC) funding. To access CHC, a GP or healthcare professional submits a referral. A multidisciplinary team (MDT) – including nurses, doctors, social workers and mental health professionals – assesses the individual.

The MDT uses a detailed CHC decision support tool that evaluates areas such as communication, mobility, cognition, and breathing.

Whether you are self-funding or using a personal health budget, Hometouch can match you with carers who have the expertise to meet your loved one’s needs. We can follow existing care plans or create new ones, provide specialist training for carers and support workers, and offer continuous clinical oversight from our nursing team.

For healthcare professionals

Hometouch works with commissioners, CCGs, case managers, and NHS trusts to deliver safe, reliable, and person-centred complex care. We help ensure continuity, prevent service gaps, and support consistent quality across the UK.

“Complex care isn’t just about medical tasks – it’s about coordinating multiple needs safely at home. Our clinical team assesses each situation thoroughly, ensuring carers have the right training and support to deliver specialist care with confidence.” – Dimple Chandarana, Head of Clinical Governance at Hometouch.

What conditions usually require complex care?

Conditions such as spinal injuries, neurological disorders, severe mobility limitations, and respiratory conditions often require complex care. This is due to the need for specialist equipment and clinical oversight.

Is complex care the same as continuing healthcare?

Not always. Complex care describes the type of support someone receives. Continuing healthcare (CHC) refers to the NHS funding that may cover the cost of that care if eligibility criteria are met.

Can complex care be delivered at home?

Yes. Many people prefer to receive complex care at home. Specialist carers can support daily living, medical needs, and rehabilitation while preserving independence and comfort in familiar surroundings.

Who decides whether someone receives NHS-funded complex care?

A Clinical Commissioning Group (CCG) makes the final decision. This is based on assessments carried out by a multidisciplinary team.

What if my loved one is not eligible for NHS funding?

Local authorities may provide means-tested support. Families may also choose self-funding, personal health budgets, or mixed funding options.

Navigating complex care funding and eligibility can feel overwhelming, particularly when you’re managing significant health needs for someone you love. Whether your family member qualifies for NHS continuing healthcare or you’re exploring self-funding options, the priority remains the same: ensuring they receive skilled, consistent care that respects their dignity and clinical requirements.

At Hometouch, our clinical team works with families, case managers, and healthcare professionals to deliver specialist complex care at home. We create custom care plans guided by nursing oversight, matching your loved one with carers who have the expertise their condition requires.

If you’d like to discuss complex care options for your family, our care experts are here to provide clear guidance.