South WestICB

Why Cornwall and the Isles of Scilly Approves Only 14.2% of CHC Applications

Cornwall has one of the lowest CHC eligibility rates in England — just 36.9 per 50,000 population, compared to a national range stretching above 300 in some areas. With 92% of the county classified as rural and over a quarter of residents aged 65+, families here face unique geographical and demographic challenges when applying for CHC funding.

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

14.2%

Approval rate 2024/25

19.5%

National average

9 / 36

England rank

Approval rate 2024/25

14.2%

National avg: 19.5%

England rank

9 / 36

1 = lowest approval rate

CHC team contact

ciosicb.chc@nhs.net

01726 627800

Understanding CHC in Cornwall and the Isles of Scilly

Cornwall's CHC landscape is defined by two intersecting pressures: an ageing population with high levels of chronic disease, and a vast rural geography that makes delivering and accessing care exceptionally difficult. The county has significantly higher rates of cardiovascular disease (8.5% vs 7.2% nationally), diabetes (6.8% vs 6.0%), and COPD (2.1% vs 1.6%) — conditions that frequently involve complex, health-led care needs that should qualify for CHC funding.

Yet Cornwall's CHC eligibility rate is among the lowest in England. This suggests either particularly strict application of the "primary health need" test, or systemic barriers that prevent families from reaching the assessment stage. The ICB's gross social care expenditure is 19% above the England average (£56,809 vs £47,758 per 100,000 people), which may indicate a local tendency to classify complex needs as "social care" rather than health-funded.

Geography creates practical obstacles at every stage. The CHC assessment team is based at Praze-an-Beeble near Camborne — a location that can be over an hour's drive from the north and east of the county. Care agencies are often reluctant to take on packages requiring 30+ minutes of travel each way (travel time is typically unpaid), leaving families in remote areas with fewer care options and potentially inflated costs that strengthen the case for NHS-funded provision.

Residents of the Isles of Scilly face additional challenges: limited on-island healthcare infrastructure means many conditions require helicopter or boat transfer to the mainland, creating distinctive coordination demands that should be factored into any CHC assessment. For families in far north or east Cornwall, the nearest acute hospital may be in Plymouth or Barnstaple — technically in different ICB areas — which can complicate the flow of medical evidence.

CHC approval statistics for Cornwall and the Isles of Scilly

Source: NHS England official CHC statistics, 2024/25 · Rank 9 of 36 ICBs in England

Near national average(-5.3pp vs national avg)

Standard approval rate

14.2%

National avg: 19.5%

Assessments completed

530

75 found eligible

Fast-track approved

49

of 49 fast-track assessments

Local review requests

34

41.2% changed to eligible

Currently receiving CHC

395

Snapshot Q3 2025/26

England rank

9 / 36

1 = lowest approval rate

How Cornwall and the Isles of Scilly compares — 2024/25

This ICB
14.2%
National avg
19.5%
England best
42.4%
England worst
5.9%

Three-year approval rate trend

2022/23
10.5%
2023/24
7.8%
2024/25 (latest)
14.2%

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

What this means

Cornwall and the Isles of Scilly's 14.2% approval rate sits broadly in line with the national average of 19.5%. Roughly 1 in 7 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 Cornwall and the Isles of Scilly

NHS Continuing Healthcare (CHC) is assessed and funded by your local Integrated Care Board. If you live in the Cornwall and the Isles of Scillyarea, 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 Cornwall and the Isles of Scilly CHC team on 01726 627800 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 Cornwall and the Isles of Scilly

These tips are specific to applying for CHC in the Cornwall and the Isles of Scilly area.

action

Document the specific travel distances and times between the person's home and their healthcare services. In rural Cornwall, this can be a powerful piece of evidence demonstrating the complexity and health-led nature of care needs.

action

If the person receives care from hospitals outside Cornwall (e.g. Derriford in Plymouth or North Devon District Hospital), make sure medical records from those trusts are included in the assessment. Cross-boundary evidence sometimes gets missed.

action

Cornwall Council sends a representative to all DST assessments. Prepare for the social care perspective to be well-represented — you should ensure the health perspective is equally well-evidenced.

action

Highlight the care agency recruitment challenges in your area. If professional care providers are unwilling to serve a remote location, this strengthens the argument that care needs are beyond what the local authority can reasonably provide.

action

The ICB operates three Integrated Care Areas (Central, North & East, West). Check which ICA your area falls under, as verification panel schedules and local contacts may differ.

action

For Isles of Scilly residents, emphasise the logistical complexity of healthcare delivery — mainland transfers, limited specialist access, and isolation all support the "primary health need" argument.

Hospital trusts in Cornwall and the Isles of Scilly

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.

Royal Cornwall Hospitals NHS Trust

Royal Cornwall Hospital (Truro), West Cornwall Hospital (Penzance), St Michael's Hospital (Hayle)

Cornwall Partnership NHS Foundation Trust

Community hospitals, Mental health services, Isles of Scilly services

Contact Cornwall and the Isles of Scilly

Address

NHS Cornwall and Isles of Scilly ICB, Part 2S, Chy Trevail, Beacon Technology Park, Dunmere Road, Bodmin PL31 2FR

Visit the official Cornwall and the Isles of Scilly CHC page →

Frequently asked questions

Why is Cornwall's CHC eligibility rate so low?

Cornwall's rate of 36.9 eligible people per 50,000 population is among the lowest in England. While the reasons aren't officially stated, contributing factors likely include strict local application of eligibility criteria, high social care expenditure that may absorb borderline cases, and rural access barriers that prevent some families from reaching the assessment stage. If you believe your loved one has been wrongly refused, you have the right to appeal.

How do I apply for CHC in Cornwall?

Contact your GP, hospital ward, or the Cornwall CHC team directly on 01726 627800 or email ciosicb.chc@nhs.net to request a Checklist screening. You can do this whether the person is at home, in hospital, or in a care home. Anyone can request a screening — you don't need a professional referral.

What if I live on the Isles of Scilly?

Isles of Scilly residents are covered by NHS Cornwall and the Isles of Scilly ICB. The same CHC process applies, but the geographical isolation of the islands — including the need for mainland transfers for specialist care — should be factored into your assessment as evidence of healthcare complexity. Contact the CHC team at ciosicb.chc@nhs.net.

My relative is treated at a hospital outside Cornwall. Can they still apply for CHC here?

Yes. CHC eligibility is based on where the person is registered with a GP, not which hospital treats them. If they're registered with a Cornwall GP, the Cornwall ICB handles their CHC assessment. Make sure to gather medical evidence from all hospitals involved in their care, including out-of-area trusts like Derriford (Plymouth) or North Devon.

Official resources

CHC funding support for families in Cornwall and the Isles of Scilly

Unsure whether your case qualifies?

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