A Daily Telegraph investigation has raised serious questions about the way NHS Continuing Healthcare is being assessed and withdrawn, including the widespread use of remote assessments for some of the country’s most vulnerable patients. Behind the statistics are families dealing with dementia, cancer, paralysis and terminal illness who say they have been forced to fight the system for essential care at precisely the moment they are least equipped to do so, raising urgent questions about NHS patient care.
For most people, the NHS promise is straightforward: healthcare is provided according to clinical need, not ability to pay. But for people with severe, complex and long-term conditions who need care outside hospital, the reality can be considerably more complicated.
NHS Continuing Healthcare (CHC), introduced in 2007, provides NHS-funded care for adults whose needs meet the required threshold. Unlike local-authority social care, it is not means-tested.
For families facing dementia, terminal cancer, spinal injury or other life-changing conditions, qualifying for CHC can therefore make an enormous difference. Yet a major investigation by The Telegraph suggests that access to this support is becoming increasingly difficult.
Only 18% of applicants received CHC funding between January and March 2026, according to figures cited by the newspaper, compared with 27% during the equivalent period in 2018 — despite no change to the eligibility criteria.
At the same time, thousands of assessments are being conducted remotely. The practice began out of necessity during Covid. But according to The Telegraph, virtual assessments have persisted and in some areas become commonplace, despite the NHS National Framework describing meeting the person being assessed as best practice.
For families, the consequences can be painfully human.
The case of Andrea White
Andrea White had dementia. According to her stepson, Mat Thorneton-Field, the 60-year-old was doubly incontinent, unable to walk or communicate, had to be hoisted and repositioned because of the danger of pressure sores, and required assistance with eating and drinking because of a serious choking risk.
Her assessment for NHS Continuing Healthcare was nevertheless conducted remotely. The conclusion was that she did not qualify. “I don’t know what else she needed to be suffering from to qualify,” Mr Thorneton-Field told The Telegraph.
His description of Andrea’s daily life is particularly difficult to reconcile with the apparent impersonality of the assessment process. She could not speak. She required thickened liquids and, according to her stepson, could be given her favourite tea by the teaspoon because of the danger of choking.
Yet the written assessment reportedly described her as capable of feeding herself with supervision and stated that she was not experiencing frequent coughing or choking episodes. Mr Thorneton-Field strongly disputed that assessment. “She was at severe risk of choking on her own saliva or drink and food,” he told the newspaper.
There were other disturbing details. The Telegraph reported that the assessment document repeatedly referred to Andrea as “he” and, at one point, apparently called her by another woman’s name. Andrea died in March. Her family is still appealing the decision.
“The whole thing was completely overwhelming and nobody was there to advocate for Andrea,” Mr Thorneton-Field said. “How many families are being crushed and ruined by this?”
A system under financial pressure
The controversy comes as Integrated Care Boards (ICBs), which make CHC funding decisions, face intense pressure to reduce expenditure.
The Telegraph reports that ICBs were instructed to halve their costs as part of wider NHS reforms, while 64% of NHS trust and ICB leaders surveyed said they were likely to reduce patient services in 2026-27 to meet financial plans.
The newspaper has also investigated the outsourcing of elements of CHC assessment and review to private company Liaison Group. According to The Telegraph, Liaison receives 33% of savings when some or all of a patient’s CHC funding is withdrawn and has saved three ICBs more than £3 million.
Liaison says its role is to provide recommendations rather than make clinical decisions and that its clinical staff are not given financial targets. Nevertheless, the arrangement raises an obvious question: should any financial incentive exist around decisions that can remove care funding from severely ill people?
The human cost of losing funding
Another family quoted by The Telegraph described an elderly woman who was extremely frail and suffering from breast cancer.
She had been receiving CHC funding. Then it stopped. Her daughter’s description of what happened is devastatingly simple: “My mother had CHC. She was elderly, extremely frail and had breast cancer. One day her CHC funding stopped, but she still had breast cancer the next day.”
Nothing material about her condition had improved. “In effect,” her daughter concluded, “she had lived too long.”
These stories illustrate why decisions about continuing care cannot be treated simply as administrative exercises. For the patient, the question may determine how they spend the final months or years of their life. For their family, it can mean suddenly having to navigate care arrangements, appeals and potentially enormous financial liabilities while simultaneously coping with the deterioration of somebody they love.
Can a video call really see the patient?
Remote medicine has an important role to play. Technology can improve access, reduce unnecessary journeys and make it easier for clinicians to participate in a patient’s care. Indeed, remote diagnostics are now widely used around the world and form an important part of the service offered by MMG’s fully accredited hospitals, enabling specialists to review diagnostic tests remotely and saving patients time, expense and unnecessary travel — particularly when they are already in pain or have limited mobility.
But assessing an extremely frail, cognitively impaired or non-verbal person to determine the true extent of their day-to-day care needs is in an entirely different category. A screen may not reveal how someone moves, eats, breathes or interacts with carers. It may not adequately demonstrate the physical environment around them or the cumulative complexity of their needs.
The Spinal Injuries Association told The Telegraph that CHC decisions are “too important to be reduced to a video call as a matter of convenience”, warning that virtual assessments can miss the physical reality of someone’s condition.
Former NHS manager David Lee was similarly critical, saying that video assessments had become convenient for clinicians but could result in people “not being assessed properly”.
The Telegraph is now campaigning for reform, including face-to-face assessments wherever possible, an independent investigation into private-sector involvement and financial incentives, a mandatory three-month review following withdrawal of CHC funding, better staff training, faster appeals and genuinely multidisciplinary assessments.
Those proposals deserve serious consideration.
The wider problem for the NHS
For My Medical Gateway, this investigation highlights something broader than Continuing Healthcare.
Across the health service, immense financial and capacity pressures are increasingly influencing how patients experience healthcare — from lengthy elective surgery waiting lists to access to specialists, rehabilitation and continuing care.
Technology can undoubtedly help solve some of these problems, and greater investment in technology and AI across the NHS should ultimately deliver faster, more efficient and better outcomes for patients. MMG itself is built around using digital technology to make healthcare easier to access, compare and navigate, and the day is fast approaching when patients will be able to search for, compare and book self-pay medical treatment directly through an AI agent.
But technology should bring patients and healthcare closer together, not create distance between vulnerable people and the professionals making life-changing decisions about their care.
Andrea White was not a checklist on a video screen. She was a seriously ill woman who could not walk or speak and whose family believed she needed round-the-clock care.
That distinction should sit at the heart of any reform. Because when a healthcare system becomes so stretched that convenience, capacity and cost begin to overshadow the individual patient, something fundamental has gone wrong.
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