Complex care at home: What it is and who qualifies

• Complex care supports people with substantial, ongoing healthcare needs, often due to chronic illness, disability, or recovery from serious injury.
• It goes beyond standard home care. Complex care involves trained clinical support for health conditions that require specialist knowledge, equipment, or ongoing medical monitoring.
• Eligibility for NHS-funded continuing healthcare (CHC) depends on whether a person’s primary need is a health need, assessed by a multidisciplinary team through Clinical Commissioning Groups (CCGs).
• If NHS funding isn’t available, support may still be accessible through means-tested local authority funding, personal health budgets, or self-funding arrangements.
• Hometouch provides doctor-founded, clinically led complex care at home – with custom care plans, specialist carer matching, and continuous nursing oversight.

Complex care provides skilled, specialist support for people whose health needs go beyond what standard home care can address. It’s delivered by trained carers working as part of a wider clinical team, following a care plan developed and regularly reviewed by nurses.

It may support people living with:

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

Depending on the person’s needs, complex care may include medication administration, management of specialist equipment such as ventilators or PEG feeding systems, catheter and stoma care, airway management, and seizure monitoring – all delivered at home under clinical supervision.

Standard home care helps with everyday tasks – personal care, meals, medication reminders, and companionship. Complex care goes further. It involves trained clinical support for conditions that require specialist knowledge, equipment, or ongoing medical monitoring.

The key distinction is the level of clinical need. If a person’s primary need is health care – not just day-to-day practical support – complex care is likely the right approach. The carer works as part of a wider clinical team, not independently.

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,
• Self-funding arrangements.

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

What does the complex care assessment involve?

A care needs assessment identifies how best to support the individual – regardless of whether NHS funding is ultimately approved. It evaluates health conditions, daily living needs, safety risks, quality of life, and medical complexity. The assessment focuses entirely on the nature of the person’s needs, not on where care is delivered or who provides it.

The process typically involves:

• 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.

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 using 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 your family member with carers who have the expertise their condition requires.

Our clinical team can follow existing care plans or create new ones from scratch, provide specialist training for carers and support workers, and offer continuous nursing oversight throughout the care journey.

As Dimple Chandarana, Head of Clinical Governance at Hometouch, explains: “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.”

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.

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.