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NHS Confederation responds to new analysis suggesting continuing healthcare is failing to reach some of the most unwell patients

ICBs’ ambition to deliver the best possible services is being seriously challenged by the very difficult financial and operating environment.

26 September 2025

Responding to a new Nuffield Trust analysis suggesting continuing healthcare (CHC) is failing to reach some of the most unwell patients in England, Sarah Walter, director of the NHS Confederation’s ICS Network, said:

"This report sheds a light on how spending and referral rates for vital continuing healthcare (CHC) services vary significantly across the country. System leaders are committed to supporting the most vulnerable and complex patients in their areas, and this research alongside the recently published NHSE guidance provides some helpful analysis to understand current performance and areas of improvement. 

"Pressure on CHC services will be even greater in an environment where integrated care boards (ICB) have been tasked with halving their running costs. ICBs’ ambition to deliver the best possible services for those with the most complex needs is being seriously challenged by the very difficult financial and operating environment."