Last Updated on June 4, 2026
There has been a near 30% rise in rejections for NHS-funded social care support, new King’s Fund research finds. The proportion of recipients of Fast Track NHS Continuing Healthcare (CHC) packages, which provide NHS-funded health and social care support for those with a rapidly deteriorating condition which may be entering a terminal phase, found no longer to be eligible upon reassessment has risen by almost 30% since 2017/18 despite the criteria for support having remained unchanged.
It comes as the think-tank has published a new report which sets out recommendations for how the NHS and the social care system interact with each other, including a review into the decline of CHC eligibility rates. The King’s Fund also discussed the issues in the social care system, including those raised in this report, at its Social Care Summit on 2nd June.
CHC packages cover patients' health and social care costs, meaning any removal or rejection of support can have major financial implications for individuals and their families. Without CHC support, people risk being pushed into the means-tested social care system that could leave them without any funding and facing high personal costs for their care. The loss of support can disrupt care arrangement and increase distress, particularly for people with deteriorating or life limiting conditions.
The King's Fund analysis found that the number of recipients of Fast Track CHC found to be no longer eligible upon reassessment increased by 28.21% between 2017/18 Q1 (earliest data available) and 2025/26 Q4 (latest data available). This is despite the criteria for support not changing. The research also found that the proportion of applicants for Standard CHC assessed as eligible (sometimes referred to as the assessment conversion rate) in April-June 2017 was 31.25%. That compared to an eligibility rate of just 16.65% in January-March 2026. This equates to a fall in eligibility from nearly one in three nine years ago to less than one in five today.
There are also significant regional disparities in eligibility rates. Individual integrated care boards (ICBs), who commission NHS services by assessing needs, planning and prioritising, purchasing and monitoring health services, are responsible for assessing CHC eligibility. In the Cambridge and Peterborough ICB, 35.37% of people assessed for standard CHC were found eligible in January-March 2026. This compares with just 2.26% in Gloucestershire.
In its new report, titled, No man's land: the experience of patients at the interface between health and social care, The King's Fund calls for a review into the decline in CHC eligibility and the rise in reassessments, with a particular focus on reducing unwarranted variation between areas. It also calls for stronger national oversight and more consistent application of the CHC framework to help ensure fairer access, a simplified and more transparent process with better communication to patients and their loved ones, and for health and social care systems to share responsibility for outcomes, supported by aligned incentives, pooled budgets and better data.
More fundamentally, it says that eligibility to publicly funded social care should be widened to reduce reliance on boundary decisions like CHC and ease pressure at the NHS and social care interface, calling on the Government-initiated independent Casey Commission into social care reform to put this forward as one of its recommendations in its final report.
Commenting on the new findings, Katie Purbrick-Thompson and Niamh Buckingham, co-authors of the report and Policy Advisers at The King's Fund, 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.
'Whether it be funding pressures making ICBs more reluctant to put in place support or because of the complex and different structures that the NHS and social care operate within, people who have seen their eligibility revoked, especially those at the end of their life, deserve answers as to why this is happening and why there is such geographical variation. 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. It would reduce reliance on these complex boundary decisions like CHC and give a clear line of accountability for who is responsible for this patient's care. We strongly urge the Casey Commission to pick up this mantle and recommend a widening of social care support in its final report.'
Gerard Crofton-Martin, Interim Chief Executive at the Social Care Institute for Excellence (SCIE), said, 'The "no man’s land" that exists between health and social care because of support delays, confusion, and service fragmentation leaves too many people without the care and support they need to live well and independently. The Government has repeatedly sought to address this through legislation. As this report makes clear, however, success has been limited. We know that ambitions have been unevenly realised, with persistent differences in people's access to services, their experiences of those services, and the outcomes they achieve.
'Improving how people navigate services must be a priority. This means ensuring information and advice are accessible and timely, and can support everyone to understand their rights and the options available to them. Adopting a holistic approach that considers someone's journey across health and social care systems will also be essential - the Government's own review of the NHS made clear that we need stronger community-based support to prevent needs escalating and to better sustain people’s health and wellbeing over time.
'With demand for care continuing to rise and more people forced to self-fund their care because they don't qualify for local authority support, the need for a national conversation on the future of social care has never been greater. The Casey Commission offers an opportunity to build an evidence base for a system that is fairer, more sustainable, and better able to support everyone, regardless of who they are and where they live, to lead fulfilling lives.'
To read No man's land: the experience of patients at the interface between health and social care, visit the King's Fund website.
In other news, the National Care Forum (NCF) has announced the national rollout of its Care Technologist Training Programme.