West MidlandsICB

Why Birmingham and Solihull Approves Only 8.2% of CHC Applications

Birmingham and Solihull is England's second largest city-region ICB, serving 1.36 million people across two areas with starkly different health profiles. Birmingham has 51% ethnic minority population and is the 7th most deprived local authority in England, while Solihull is significantly more affluent — creating a CHC landscape shaped by deep health inequalities.

Information last verified: 2026-04-06 · England CHC framework

8.2%

Approval rate · 12 months to June 2026

17.7%

National average

4 of 36

4th lowest approval rate of 36 ICBs

Approval rate · 12 months to June 2026

8.2%

National avg: 17.7%

England ranking

4 of 36

4th lowest approval rate of 36 ICBs

CHC team contact

contactusbsolics@nhs.net

0121 203 3300

Understanding CHC in Birmingham and Solihull

The health divide between Birmingham and Solihull is one of the starkest within any single ICB area in England. Male life expectancy in Birmingham is 75.9 years compared to 79.6 in Solihull — a 3.7-year gap that reflects decades of entrenched deprivation. Within Birmingham itself, 43% of the population lives in the most deprived 10% of neighbourhoods nationally, and the city has significantly higher rates of diabetes, cardiovascular disease, and preventable mortality.

For CHC applicants, this matters because many residents present with complex, multi-domain health needs rooted in long-term deprivation and chronic disease. Getting to a full DST assessment is the real challenge here: NHS England's own published figures show Birmingham and Solihull approves just 8.2% of standard CHC assessments over the 12 months to June 2026 — one of the lowest rates in England, well below the 17.7% national average. The initial Checklist screening is a significant filter, and cases that do reach assessment still face a tougher-than-average bar.

Birmingham's ethnic diversity adds another layer. Over half of Birmingham's population is from ethnic minority backgrounds, with particularly large South Asian and Black Caribbean communities. Language barriers, cultural attitudes to formal care, and health conditions with higher prevalence in specific ethnic groups (such as Type 2 diabetes in South Asian populations) all influence the CHC process. Interpretation services should be available, and culturally appropriate advocacy can make a real difference.

The ICB runs regular CHC Checklist training sessions for care home staff (first Thursday of each month, 2-4pm), which suggests a structured approach to referrals from residential settings. For families whose relative is in a care home, asking the home manager whether their staff have attended this training can be a useful first step.

CHC approval statistics for Birmingham and Solihull

Standard-route assessments, 12 months to June 2026. How we calculate this

Below the national average(−9.5pp)

Approval rate

8.2%

National average: 17.7%

Assessments completed

1,139

93 found eligible

England ranking

4 of 36

4th lowest approval rate of 36 ICBs

Currently receiving CHC

785

30.8 per 50,000 adults

Local resolution requests

26

3 changed to eligible (11.5%)

Year-on-year change

−5.5pp

vs the previous 12 months

How Birmingham and Solihull compares — 12 months to June 2026

This ICB
8.2%
National average
17.7%
Highest ICB
43.1%
Lowest ICB
5.0%

See all 36 ICBs ranked

Quarterly approval rate, last 12 quarters

Individual quarters move for reasons unrelated to how an ICB assesses — a backlog cleared in one period can swing the rate sharply. The 12-month figure above is the more reliable measure.

Standard-route CHC approval rate by quarter for this ICB, with assessments completed and found eligible.
QuarterAssessedEligibleRate
Jul–Sep 202336560
16.4%
Oct–Dec 202330839
12.7%
Jan–Mar 202433841
12.1%
Apr–Jun 202437339
10.5%
Jul–Sep 202431234
10.9%
Oct–Dec 202437552
13.9%
Jan–Mar 202538661
15.8%
Apr–Jun 202529040
13.8%
Jul–Sep 202529929
9.7%
Oct–Dec 202530515
4.9%
Jan–Mar 202624722
8.9%
Apr–Jun 2026 (latest)28827
9.4%

Ranked 4 of 36 ICBs on the 12-month rate · Source: NHS England

What this means

Birmingham and Solihull found 8.2% of people assessed through the standard route eligible over the last 12 months — 9.5 percentage points below the national average of 17.7%, and 4th lowest approval rate of 36 icbs. Research by the Nuffield Trust attributes this kind of variation to how the National Framework is applied locally rather than to differences in clinical need. If you have been refused here, the quality of your evidence and a well-argued local resolution request are the levers within your control.

See how every ICB compares: the CHC approval rate ranking for all 36 ICBs.

How to apply for CHC funding in Birmingham and Solihull

NHS Continuing Healthcare (CHC) is assessed and funded by your local Integrated Care Board. If you live in the Birmingham and Solihullarea, here's what you need to know.

Step 1: Request a CHC screening

You can request a CHC Checklist screening at any time — in hospital, at home, or in a care home. Contact your GP or the Birmingham and Solihull CHC team on 0121 203 3300 to start the process.

Step 2: The Checklist assessment

A healthcare professional will complete the CHC Checklist with you. If you score positively on two or more domains (or one domain at "priority" level), you'll be referred for a full assessment.

Step 3: The full Decision Support Tool assessment

A multidisciplinary team will carry out a comprehensive assessment using the Decision Support Tool (DST). This evaluates your needs across 12 care domains.

Advocacy tips for Birmingham and Solihull

These tips are specific to applying for CHC in the Birmingham and Solihull area.

action

Birmingham's high deprivation levels mean many CHC applicants have complex, overlapping health needs. Build your evidence around the interplay between conditions — the DST is designed to assess cumulative complexity, not individual diagnoses in isolation.

action

If English isn't the first language in your family, you have the right to interpretation services during CHC assessments. Request this in advance so the ICB can arrange a qualified interpreter.

action

University Hospitals Birmingham (UHB) is one of the largest hospital trusts in England with four major sites. If your relative is being discharged from a UHB hospital, the discharge team should offer a CHC Checklist screening before any move to a care home or home care package.

action

For Birmingham residents, the advocacy service Pohwer (0300 456 2370) provides free support including help with CHC. Solihull residents can access Solihull First Advocacy (0121 706 4696).

action

The ICB's monthly CHC training for care homes suggests they value structured referrals. If your relative's care home hasn't completed the Checklist, ask the home manager to request training from the CHC team.

action

Pay attention to the deprivation-linked health conditions prevalent in Birmingham — diabetes, cardiovascular disease, respiratory conditions — and how these create health-led (not just social) care needs.

Hospital trusts in Birmingham and Solihull

These are the main NHS trusts whose patients may be assessed for CHC in this area. If your relative is being discharged from one of these hospitals, ask the ward about CHC screening.

University Hospitals Birmingham NHS Foundation Trust

Queen Elizabeth Hospital, Heartlands Hospital, Good Hope Hospital, Solihull Hospital

Birmingham Women's and Children's NHS Foundation Trust

Birmingham Children's Hospital, Birmingham Women's Hospital

Birmingham Community Healthcare NHS Foundation Trust

Community services across Birmingham and Solihull

Birmingham and Solihull Mental Health NHS Foundation Trust

Specialist mental health services

The Royal Orthopaedic Hospital NHS Foundation Trust

Royal Orthopaedic Hospital

Contact Birmingham and Solihull

Address

NHS Birmingham and Solihull ICB, 1st Floor Wesleyan, Colmore Circus, Birmingham B4 6AR

Visit the official Birmingham and Solihull CHC page →

Frequently asked questions

What is the CHC approval rate in Birmingham and Solihull?

NHS England's published figures show Birmingham and Solihull approves 8.2% of standard CHC assessments over the 12 months to June 2026 — one of the lowest rates in England, against a national average of 17.7%. The initial Checklist screening filters out many applicants before they reach a full DST assessment, and cases that do proceed still face a tougher-than-average bar. Getting a positive Checklist is the first critical step, and the quality of evidence at DST stage matters more here than in higher-approving areas.

Can I get CHC assessment support in my own language?

Yes. The ICB must provide interpretation services for CHC assessments. If English isn't your family's first language, request an interpreter when you schedule the assessment. Birmingham has particularly strong provision for South Asian languages (Urdu, Punjabi, Bengali) and Arabic.

My relative is in a Birmingham care home. Should the home help with CHC?

Care home staff can and should complete CHC Checklists for residents who may have a primary health need. NHS Birmingham and Solihull runs monthly training sessions for care home nursing staff (first Thursday, 2-4pm). Ask the home manager whether their team has attended this training and whether they've considered a CHC screening for your relative.

Is there free advocacy support available in Birmingham?

Yes. Pohwer provides free advocacy for Birmingham residents (0300 456 2370), including help navigating CHC. Solihull residents can contact Solihull First Advocacy (0121 706 4696). The national Beacon CHC service (0345 548 0300) also offers free advice and up to 90 minutes of personalised support.

Official resources

CHC funding support for families in Birmingham and Solihull

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