West MidlandsICB

Why Birmingham and Solihull Approves Only 12.9% 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

12.9%

Approval rate 2024/25

19.5%

National average

5 / 36

England rank

Approval rate 2024/25

12.9%

National avg: 19.5%

England rank

5 / 36

1 = lowest approval rate

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. The ICB's own materials suggest approximately two-thirds of people who proceed to a full DST assessment are found eligible — higher than the national average of around 19%. However, getting to that assessment stage is the challenge: the initial Checklist screening acts as a significant filter.

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

Source: NHS England official CHC statistics, 2024/25 · Rank 5 of 36 ICBs in England

Near national average(-6.6pp vs national avg)

Standard approval rate

12.9%

National avg: 19.5%

Assessments completed

1,446

186 found eligible

Fast-track approved

1,773

of 1,773 fast-track assessments

Local review requests

149

14.8% changed to eligible

Currently receiving CHC

1,116

Snapshot Q3 2025/26

England rank

5 / 36

1 = lowest approval rate

How Birmingham and Solihull compares — 2024/25

This ICB
12.9%
National avg
19.5%
England best
42.4%
England worst
5.9%

Three-year approval rate trend

2022/23
25.7%
2023/24
14.7%
2024/25 (latest)
12.9%

National average: 19.5% in 2024/25 · Source: NHS England

What this means

Birmingham and Solihull's 12.9% approval rate sits broadly in line with the national average of 19.5%. Roughly 1 in 8 people assessed receives a positive decision via the standard route. The quality of evidence presented at the DST assessment remains the single most important factor within families' control.

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.

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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?

The ICB's own materials indicate that approximately two-thirds of people who undergo a full DST assessment are found eligible for CHC — higher than the national average of around 19%. However, the initial Checklist screening filters out many applicants before they reach the full assessment stage. Getting a positive Checklist is the first critical step.

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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