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There is an unfair \u201cluck of the draw\u201d when it comes to families getting NHS<\/a> funding for their loved ones, according to a report.<\/p>\n Financial pressures are also playing a \u201ckey role\u201d in how NHS continuing healthcare (CHC) operates, \u201cwith all parts of the system facing significant pressure to keep costs down\u201d, the study from the Nuffield Trust<\/a> found.<\/p>\n CHC is a package of health and social care provided outside of hospital, which the NHS pays for.<\/p>\n It is for people who are identified as having a \u201cprimary health need\u201d but has repeatedly hit the headlines for being an unfair system.<\/p>\n Various parliamentary reports have criticised how funding is allocated across England<\/a>, while the National Audit Office<\/a> said the system can leave families without support they are entitled to.<\/p>\n Some families have taken local health organisations to court to win CHC funding after being turned down.<\/p>\n In the latest analysis, researchers found CHC is failing to reach some of the most unwell patients in England.<\/p>\n They said the current CHC framework reinforces deep regional inequalities, with variations in who is eligible for funding, and less being spent per person in deprived areas and the north of England.<\/p>\n Despite overall spending on CHC increasing, the number deemed eligible for help is falling.<\/p>\n Overall, the number of people eligible for CHC fell from 57,216 at the end of June 2017 to 52,008 at the end of December 2024 \u2013 a drop of 9.1%.<\/p>\n This is being driven by fewer people being able to access longer-term CHC funding, compared with fast-track funding, which is intended to support people at the end of their lives.<\/p>\n Researchers found that, in all years with the exception of 2020\/21, there was a statistically significant fall in the average number of people eligible for CHC in the last two quarters of the financial year compared with the first two.<\/p>\n \u201cThe exact reason for this pattern is not clear, but the financial pressures the (NHS integrated care boards) are under are widely acknowledged and these may be playing a part,\u201d the report said.<\/p>\n Researchers said CHC can be a lifeline for people with significant ongoing care needs, but if someone is found ineligible they can be faced with a \u201ccliff-edge of potentially catastrophic costs\u201d.<\/p>\n Their report said: \u201cThe current situation means the stakes are high \u2013 an \u2018all or nothing\u2019 approach that is problematic and does not reflect the nature of need.<\/p>\n \u201cWith both the NHS and social care under pressure to keep costs down and allocate resources equitably, people requiring care are caught in the middle.\u201d<\/p>\n