How we calculate CHC approval rates

The source

Every CHC figure on this site comes from one place: NHS England’s Continuing Healthcare and NHS-funded Nursing Care quarterly statistics. We collect nothing ourselves and estimate nothing. The published file reports every Integrated Care Board in England each quarter, and we use the counts in it directly.

NHS England discontinued the accompanying PDF report in May 2026. The underlying data continues to be published quarterly as management information, and that is what we read.

What the rate measures

The headline figure is the standard-route approval rate: of the CHC assessments completed in a period, the share in which the person was found eligible.

approval rate = assessed eligible (standard route) ÷ assessments completed (standard route)

We sum the counts across the most recent four quarters and divide once, so larger quarters carry proportionally more weight. Over the 12 months to June 2026, England completed 51,073 standard assessments and found 9,029 people eligible — a national rate of 17.7%.

Why fast-track cases are excluded

Fast Track is the route used when someone is approaching the end of life, and it is completed by a clinician rather than decided by a panel. In NHS England’s data almost every fast-track assessment is recorded as eligible — nationally the recorded conversion rate is effectively 100%.

Including those cases would lift every ICB by a similar amount and obscure the thing families actually want to know: how the standard route is being applied where they live. We therefore report the standard route only, and say so wherever a rate appears.

Why 12 months, not the latest quarter

Single quarters move for reasons that have nothing to do with how an ICB assesses people. A backlog cleared in one period, a change in recording practice, or a small number of assessments can all swing a quarterly rate by tens of percentage points.

Four of the 36 ICBs have swung by more than 20 percentage points from one quarter to the next within the series shown here. Ranking on a single quarter would put those reporting artefacts at the top and bottom of the table. We headline a rolling 12-month rate instead, show the quarterly series underneath so the movement is visible, and flag any ICB whose own four quarters disagree sharply with each other.

ICB mergers and the historical series

Twelve ICBs were abolished on 31 March 2026 and six new ones took their place, leaving 36in England. NHS England restated its entire published back series onto that current structure, rebuilding each new ICB’s history from its predecessors’ areas.

That means the quarterly series shown for an ICB created in April 2026 legitimately extends back before the organisation legally existed — it describes the same geography under earlier management. We publish NHS England’s restated figures unchanged rather than stitching series together ourselves.

What these figures cannot tell you

A raw approval rate is not a measure of how fairly an ICB behaves. At least six things move it that are nothing to do with decision-making quality:

1. Age structure and deprivation. Populations differ in how much high-level need they contain.
2. Referral practice. An area that refers generously will assess more people who were never likely to qualify, lowering its rate without refusing anyone unfairly.
3. Where the Checklist screening happens. Filtering earlier in the process changes who reaches a full assessment at all.
4. Care-home and hospital capacity. Local provision affects who is assessed, and when.
5. Recording and reporting practice. Which cases an ICB counts as a completed standard assessment is not perfectly uniform.
6. Small numbers. Several ICBs complete only a few hundred assessments a year, so a handful of decisions moves the rate visibly.

How often we update

NHS England publishes roughly two months after a quarter ends. We refresh within seven days of each publication, regenerating every page from the new file in a single step, so no figure can drift out of step with another. Each page states the quarter it shows and the date it was last updated.

Wales is not included. Welsh Local Health Boards operate under a separate framework and a separate Welsh Government publication; our Welsh pages therefore carry contact and process information rather than comparable approval rates.

Corrections

If you believe a figure here is wrong — including if you work for an ICB and our numbers do not match your own records — email hello@careadvocate.co.uk. We will check it against the published source, correct it within five working days if it is wrong, and note what changed on this page.

Journalists and researchers are welcome to reuse these figures. NHS England’s data is published under the Open Government Licence; please cite NHS England as the source and, if the derived rates or rankings are useful, CareAdvocate for the calculation.

Common questions