Understanding CHC in Black Country
The Black Country is one of England's most deprived health system areas, with historical roots in industrial manufacturing. Today, the population contends with above-average rates of respiratory disease, cardiovascular conditions, and mental health challenges—all drivers of CHC demand. The four-borough structure (Dudley, Sandwell, Walsall, Wolverhampton) creates administrative complexity: CHC assessments may require coordination across multiple local authority boundaries, and there can be inconsistency in how domiciliary care is commissioned post-assessment.
A critical feature of this area is the severity of health inequalities. Some wards have life expectancy gaps exceeding ten years compared to the England average, and smoking prevalence remains stubbornly high. Families navigating CHC here often face additional barriers: housing instability in some areas, language diversity requiring specialist advocacy, and limited availability of care home beds—meaning even if CHC is approved, families struggle to find suitable placements locally. The NHS merged several commissioning functions in 2024-2025, which can cause delays in CHC decisions during transition periods.
Hospital capacity is also a recurring concern. The Black Country's four acute NHS trusts handle high A&E demand and lengthy inpatient stays, which can delay CHC triage if patients remain in hospital. Families should expect CHC assessments to take 28-40 working days here rather than the 28-day target, and pre-hospital discharge coordination is crucial to avoid gaps in care funding.
CHC approval statistics for Black Country
Standard-route assessments, 12 months to June 2026. How we calculate this
Approval rate
43.1%
National average: 17.7%
Assessments completed
1,087
469 found eligible
England ranking
36 of 36
Highest approval rate of 36 ICBs
Currently receiving CHC
412
19.8 per 50,000 adults
Local resolution requests
6
0 changed to eligible (0.0%)
Year-on-year change
+0.9pp
vs the previous 12 months
How Black Country compares — 12 months to June 2026
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.
The most recent quarter (19.8%) sits well away from this ICB’s 12-month average of 43.1%. A single quarter that moves this far usually reflects how decisions were recorded in that period rather than a change in approach — see methodology.
Ranked 36 of 36 ICBs on the 12-month rate · Source: NHS England
What this means
Black Country found 43.1% of people assessed through the standard route eligible over the last 12 months — 25.4 percentage points above the national average of 17.7%. That is encouraging, but a rate is an average across hundreds of cases. Individual outcomes still turn on the evidence presented at the Decision Support Tool assessment.
See how every ICB compares: the CHC approval rate ranking for all 36 ICBs.
How to apply for CHC funding in Black Country
NHS Continuing Healthcare (CHC) is assessed and funded by your local Integrated Care Board. If you live in the Black Countryarea, 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 Black Country CHC team on 0300 0120 281 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 Black Country
These tips are specific to applying for CHC in the Black Country area.
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Request early CHC contact from the hospital discharge team—do not wait for your relative to leave hospital to start the assessment process.
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Document all health interventions and multidisciplinary team input in writing; the Black Country uses paper-heavy systems and lost records are common.
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Escalate to your local Healthwatch or council CHC champion if assessment timelines slip beyond 40 days; delays here often indicate staffing shortages.
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Prepare for cross-borough coordination issues: if your relative may move between boroughs, secure CHC funding in writing before the move.
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Seek advocacy support early if you need help communicating in languages other than English; provision varies by borough.
Hospital trusts in Black Country
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.
Sandwell and West Birmingham Hospitals NHS Trust
The Dudley Group NHS Foundation Trust
Dudley Hospital, Corbett Hospital
The Royal Wolverhampton NHS Trust
New Cross Hospital, Royal Hospital
Walsall Healthcare NHS Trust
Black Country Healthcare NHS Foundation Trust
Contact Black Country
Phone
0300 0120 281Website
Visit website →Address
Black Country ICB, Civic Centre, St Peter's Square, Wolverhampton, WV1 1SH
Frequently asked questions
How long does a CHC assessment take in the Black Country?
The national target is 28 days, but the Black Country frequently exceeds this due to staffing and administrative capacity constraints. Realistic timelines are 35-45 working days. If your assessment exceeds 40 days without explanation, contact your case manager or escalate via Healthwatch.
Are there specialist CHC teams for children in the Black Country?
Children's CHC assessments are coordinated through the main Black Country ICB CHC team. Contact the main switchboard (0300 0120 281) and ask to be transferred to the children and young people's continuing care team, which operates separately from adult services.
What if I disagree with the CHC decision?
Contact the Black Country ICB CHC team within 28 days of the decision letter and request a local resolution meeting. If you remain dissatisfied, you can request an Independent Review Panel hearing. This process typically takes 12-16 weeks.
Can I arrange private CHC assessment in parallel with the NHS process?
Yes. Many families commission independent medical reports to strengthen their case. The NHS cannot prohibit private assessment, though NHS evidence will be the primary basis for their decision. Ensure your private assessor is familiar with the DST (Decision Support Tool) framework.