South WestICB

CHC Funding in Bristol, North Somerset and South Gloucestershire: The 15.9% Approval Rate Explained

Bristol, North Somerset and South Gloucestershire is one of England's most dynamic urban ICB areas, spanning a historic city with significant deprivation pockets, affluent commuter towns, and coastal resort communities. Its CHC landscape is shaped by dense urban health needs, marked health inequalities (ranking 23rd-27th worst nationally for healthy life expectancy gaps), and a hidden crisis of unpaid family caregiving—nearly 1 in 10 people aged 65+ provide care for someone else.

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

15.9%

Approval rate 2024/25

19.5%

National average

13 / 36

England rank

Approval rate 2024/25

15.9%

National avg: 19.5%

England rank

13 / 36

1 = lowest approval rate

CHC team contact

bnssg.chcteam@nhs.net

0117 900 2626

Understanding CHC in Bristol, North Somerset and South Gloucestershire

Bristol itself represents a tale of stark contrasts. The city's creative industries and prosperous northern postcodes mask some of England's deepest pockets of deprivation in inner-city wards. This inequality translates directly to health outcomes: Bristol ranks as the 27th worst area in England for healthy life expectancy in males and 23rd worst for females, indicating a significant proportion of the population is aging with preventable disease and disability. For CHC applicants living in deprived inner-Bristol postcodes, this context matters: health complexity cannot be separated from the social determinants that created it.

A demographic marker specific to BNSSG is the concentration of older people providing unpaid care. Over 6,660 residents aged 65+ are themselves caring for someone else—nearly 1 in 10 of Bristol's older population. This is not simply a matter of familial support; many are carer-dependent pairs, where one partner's decline triggers demand for CHC assessment of the other. This pattern is crucial for advocacy: if your case involves an elderly carer who will collapse without formal support, or a care-recipient whose carer is themselves elderly and frail, frame this as evidence that informal care is unsustainable and NHS-funded care is essential.

BNSSG's health infrastructure is anchored by two major NHS trusts. North Bristol NHS Trust operates Southmead Hospital, a regional centre for orthopedics, neurosciences, renal, and transplant services—meaning many BNSSG residents have complex specialist conditions requiring coordinated care. University Hospitals Bristol and Weston NHS Foundation Trust similarly runs multiple specialist centres. For CHC assessments, the availability of in-depth specialist input from these trusts is an asset; applicants should actively request involvement of relevant consultants early in the DST process.

A final BNSSG-specific dynamic is the mixed urban-rural character. Coastal North Somerset (Weston-super-Mare, Clevedon) and peripheral South Gloucestershire areas experience different access challenges than inner Bristol. Rural North Somerset applicants may struggle with transport to assessment appointments and limited local care availability. Urban Bristol applicants, by contrast, may face tighter cost-control scrutiny from an ICB managing a million-person urban population. Tailor your advocacy to your locality.

CHC approval statistics for Bristol, North Somerset and South Gloucestershire

Source: NHS England official CHC statistics, 2024/25 · Rank 13 of 36 ICBs in England

Near national average(-3.6pp vs national avg)

Standard approval rate

15.9%

National avg: 19.5%

Assessments completed

916

146 found eligible

Fast-track approved

2,398

of 2,398 fast-track assessments

Local review requests

35

14.3% changed to eligible

Currently receiving CHC

827

Snapshot Q3 2025/26

England rank

13 / 36

1 = lowest approval rate

How Bristol, North Somerset and South Gloucestershire compares — 2024/25

This ICB
15.9%
National avg
19.5%
England best
42.4%
England worst
5.9%

Three-year approval rate trend

2022/23
18.0%
2023/24
14.6%
2024/25 (latest)
15.9%

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

What this means

Bristol, North Somerset and South Gloucestershire's 15.9% approval rate sits broadly in line with the national average of 19.5%. Roughly 1 in 6 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 Bristol, North Somerset and South Gloucestershire

NHS Continuing Healthcare (CHC) is assessed and funded by your local Integrated Care Board. If you live in the Bristol, North Somerset and South Gloucestershirearea, 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 Bristol, North Somerset and South Gloucestershire CHC team on 0117 900 2626 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 Bristol, North Somerset and South Gloucestershire

These tips are specific to applying for CHC in the Bristol, North Somerset and South Gloucestershire area.

action

If you live in a deprived inner-Bristol postcode, explicitly reference the health inequality data (23rd-27th worst for healthy life expectancy nationally). Show how deprivation has shaped your health trajectory. This is not social context alone—it's a documented health determinant.

action

If your case involves an elderly carer (65+), emphasize that BNSSG's research shows 6,660 older adults are currently providing unpaid care. Frame the situation: if the carer collapses, the care-recipient will need emergency formal support. Prevent crisis by funding care now.

action

For specialist conditions (renal, neuro, orthopedic, transplant), request detailed input from consultants at North Bristol Trust or UHBW early. These specialists can articulate care complexity that community practitioners might miss. Get written specialist assessments in the DST.

action

If you live in rural North Somerset or South Gloucestershire, document transport barriers: distance to assessment venues, limited local paid care, poor public transport. Frame CHC as necessary because no accessible alternative exists.

action

If assessment delays occur, escalate quickly. BNSSG manages a large urban population; cases can get queued. Document all communication dates and request a completion timeline in writing.

Hospital trusts in Bristol, North Somerset and South Gloucestershire

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.

North Bristol NHS Trust

Southmead Hospital, Orthopedics Centre, Neurosciences Centre, Renal & Transplant Services

University Hospitals Bristol and Weston NHS Foundation Trust (UHBW)

Bristol Royal Infirmary, Weston General Hospital

Contact Bristol, North Somerset and South Gloucestershire

Address

360 Bristol, Marlborough Street, Bristol BS1 3NX

Children's CHC

bnssg.chcteam@nhs.net

Visit the official Bristol, North Somerset and South Gloucestershire CHC page →

Frequently asked questions

What is a fast-track CHC assessment and how do I qualify?

Fast-track applies when someone has a rapidly deteriorating condition entering a terminal phase—advanced cancer, late-stage dementia, severe stroke complications. An appropriate clinician (nurse or doctor) completes the Fast-Track Pathway Tool instead of the standard checklist and DST. Care should be commissioned within 48 hours. Contact bnssg.fasttrack@nhs.net if you believe your case qualifies.

My relative is an older carer (65+) providing care to someone else. How does this affect CHC?

BNSSG research shows 6,660 older adults are providing unpaid care—nearly 1 in 10 of Bristol's 65+ population. This is significant. If an elderly carer's health is failing, their unsustainability as a caregiver becomes a documented health need. Build your case around: (1) the care-recipient's health complexity, and (2) the carer's inability to sustain support due to their own health decline.

We live in rural North Somerset and can't access local care services. Does this strengthen our case?

Yes. If you live in Clevedon, Weston-super-Mare hinterland, or rural South Gloucestershire, document transport barriers to assessment appointments and limited local care availability. Frame CHC as essential because no alternative exists: family support is strained, paid care is unavailable or unaffordable, and local authority services cannot meet needs.

How do health inequality and deprivation factor into CHC eligibility?

BNSSG's research shows significant health inequality—Bristol ranks 23rd-27th worst nationally for healthy life expectancy gaps. If you live in a deprived area, this is clinically relevant. Show how deprivation has contributed to health complexity, limited access to preventive care, and greater overall disease burden. This context strengthens arguments for primary health need.

Official resources

CHC funding support for families in Bristol, North Somerset and South Gloucestershire

Unsure whether your case qualifies?

CareAdvocate helps families prepare NHS Continuing Healthcare applications in the Bristol, North Somerset and South Gloucestershire area — from initial screening through to a written Case Strength Report.

Free

CHC Eligibility Screener

3 minutes · no signup

Check eligibility →

From £97

Case Strength Report

AI + expert review of your evidence

See how it works →

From £597

Checklist Evidence Pack

Domain-mapped pack ready for your assessor

See what's included →

Need help with your CHC application?

Get our free CHC funding guide — everything you need to know about applying and appealing.

Get it free — sent instantly

Enter your email and we'll send it straight to your inbox.

🔒 No spam✉️ Instant delivery↩️ Unsubscribe anytime
Free CHC eligibility check