Understanding CHC in Herefordshire and Worcestershire
This is a uniquely challenging area for CHC coordination due to geography. The two main acute hospitals—Worcestershire Royal and Hereford Hospital—are separated by more than 30 miles on single carriageway roads, typically requiring 60+ minutes to drive between them. For families, this creates practical barriers: if a relative requires hospital admission for CHC assessment or multi-disciplinary team (MDT) coordination, family attendance and regular visits become logistically difficult. Rural communities also have limited access to primary care (lengthy GP waiting times are common) and specialist services, increasing the pressure on CHC triage teams to identify health needs quickly during short assessment windows.
The population is predominantly white, but the area is experiencing demographic change driven by migrant agricultural workers—particularly from Poland and Eastern Europe—and a small but growing Asian community. CHC assessments for non-English speakers require advance interpretation booking; some rural practices have limited translation capacity. Additionally, Gypsy, Romany, and Traveller communities around Evesham and Hereford have traditionally lower health literacy and higher CHC rejection rates, suggesting systemic barriers in how assessments are conducted or communicated to these groups. Advocacy support for these communities is limited locally.
The Herefordshire and Worcestershire Health and Care NHS Trust is unusual: it is an integrated care provider delivering both hospital and community services, which can create siloed CHC decision-making between hospital and community teams. A relative may be assessed for CHC in hospital but then discharged under community care arrangements without clear handover. Families should insist on a single case manager and a clear CHC decision letter, regardless of whether care is hospital or community-based. The mid-Wales catchment (40,000 people) adds further complexity: some Welsh residents are entitled to CHC funding under English law if they use English NHS services, but eligibility can be disputed during transition periods.
CHC approval statistics for Herefordshire and Worcestershire
Source: NHS England official CHC statistics, 2024/25 · Rank 7 of 36 ICBs in England
Standard approval rate
14.1%
National avg: 19.5%
Assessments completed
1,188
168 found eligible
Fast-track approved
2,197
of 2,197 fast-track assessments
Local review requests
70
25.7% changed to eligible
Currently receiving CHC
729
Snapshot Q3 2025/26
England rank
7 / 36
1 = lowest approval rate
How Herefordshire and Worcestershire compares — 2024/25
Three-year approval rate trend
National average: 19.5% in 2024/25 · Source: NHS England
What this means
Herefordshire and Worcestershire's 14.1% 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 Herefordshire and Worcestershire
NHS Continuing Healthcare (CHC) is assessed and funded by your local Integrated Care Board. If you live in the Herefordshire and Worcestershirearea, 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 Herefordshire and Worcestershire CHC team on 0330 053 4356 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 Herefordshire and Worcestershire
These tips are specific to applying for CHC in the Herefordshire and Worcestershire area.
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If you live in a rural area, request home-based assessment or community clinic appointments rather than insisting on hospital visits; geographic hardship is a valid grounds for process adjustment.
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Document non-English speaker status in writing before assessment; request a professional interpreter and allow extra time in the assessment window for interpretation.
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If you are from a Gypsy, Romany, or Traveller community, request that Healthwatch advocates attend your assessment as an observer to ensure cultural safety and fair process.
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Clarify at the outset whether assessment will be led by hospital or community teams; request a single named case manager and written confirmation of who is responsible for CHC coordination post-decision.
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For mid-Wales residents using English NHS services: confirm eligibility status with the English ICB in writing before the assessment, as disputes over Welsh vs. English funding responsibility are common.
Hospital trusts in Herefordshire and Worcestershire
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.
Worcestershire Acute Hospitals NHS Trust
Worcestershire Royal Hospital, Alexandra Hospital, Evesham Community Hospital, Kidderminster Hospital and Treatment Centre
Herefordshire and Worcestershire Health and Care NHS Trust
Wye Valley NHS Trust
Hereford Hospital, Leominster Community Hospital
Contact Herefordshire and Worcestershire
Phone
0330 053 4356Website
Visit website →Address
Herefordshire and Worcestershire ICB, Kirkham House, John Comyn Drive, Perdiswell, Worcester, WR3 7NS
Visit the official Herefordshire and Worcestershire CHC page →
Frequently asked questions
How do I access CHC assessment if I live in a remote rural area?
You can request the assessment to take place in your home or a local community clinic rather than at a hospital. Contact your local GP or call 0330 053 4356 to arrange a home-based appointment. This avoids travel barriers and is your right under equality law.
I am a migrant agricultural worker. Am I eligible for CHC?
If you are a permanent UK resident or have been registered with a GP for 12+ months, you are eligible for NHS CHC. EU/international workers should contact the ICB directly to confirm residency status. You have the right to an interpreter if English is not your first language.
What is different about the integrated Herefordshire and Worcestershire Health and Care NHS Trust?
This trust provides both hospital and community services under one management. For CHC purposes, this means your case may transition between hospital and community teams. Ensure you receive a single written decision letter and a named case manager responsible for coordinating your care package.
Can I be assessed for CHC by the English NHS if I live in mid-Wales?
Yes, if you use English NHS services for assessment and treatment. However, your funding responsibility (Welsh or English) must be confirmed in writing before the assessment begins. If disputed, escalate to your ICB Continuing Healthcare manager.