Understanding CHC in Kent and Medway
Kent and Medway is experiencing a perfect storm of demographic pressure and financial crisis. The county's population is rapidly ageing — already 20% are 65+, and this is projected to increase 30% by 2035, the highest growth rate in the South East. Simultaneously, Kent's adult social care system is in severe financial distress, with estimated annual funding gaps of £30+ million. This creates an unusually stark reality: social care capacity is contracting even as demand surges.
For CHC purposes, this tension is critical to understand. The ICB faces intense pressure: families whose relatives would have been managed by social care in previous years are now seeking NHS funding (CHC) because social care packages are unavailable, unaffordable, or restricted. Conversely, councils are incentivised to push cases toward the NHS. This can create a perverse dynamic where families face both resistance from the NHS (budget constraints) and pressure from councils to seek NHS funding.
The ICB operates multiple large teaching and district hospital trusts: East Kent Hospitals (William Harvey in Ashford, Kent and Canterbury, and Queen Elizabeth in Margate), Medway Maritime (Gillingham), Maidstone and Tunbridge Wells, and Darent Valley. These are high-volume acute trusts with strong discharge planning but also capacity pressures. Discharge teams may be under significant time pressure — be proactive about requesting CHC screening before discharge.
The county's geography spans from London commuter belt (Dartford, Gravesham) to coastal towns (Margate, Folkestone) and rural villages. Urban vs rural care access varies dramatically, and families in remote areas may face additional barriers to finding care agencies willing to serve them. This geographic disparity is worth documenting as part of advocacy around care access barriers.
CHC approval statistics for Kent and Medway
Source: NHS England official CHC statistics, 2024/25 · Rank 27 of 36 ICBs in England
Standard approval rate
20.9%
National avg: 19.5%
Assessments completed
1,715
359 found eligible
Fast-track approved
3,941
of 3,941 fast-track assessments
Local review requests
88
20.5% changed to eligible
Currently receiving CHC
1,815
Snapshot Q3 2025/26
England rank
27 / 36
1 = lowest approval rate
How Kent and Medway compares — 2024/25
Three-year approval rate trend
National average: 19.5% in 2024/25 · Source: NHS England
What this means
Kent and Medway's 20.9% approval rate sits broadly in line with the national average of 19.5%. Roughly 1 in 5 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 Kent and Medway
NHS Continuing Healthcare (CHC) is assessed and funded by your local Integrated Care Board. If you live in the Kent and Medwayarea, 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 Kent and Medway CHC team on 01634 335095 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 Kent and Medway
These tips are specific to applying for CHC in the Kent and Medway area.
action
Understand the broader context: Kent's social care crisis is well-documented. If your relative cannot access social care due to availability or cost, frame CHC advocacy around the healthcare complexity of their needs, not the social care gap. The ICB is aware of social care pressures but will resist CHC being used as a social care substitute.
action
Document any delays or barriers to securing social care. If care agencies refuse to serve your area, or if costs are prohibitive, this can support an argument that care needs are genuinely health-led (not social care-led). Emphasize the healthcare complexity and unpredictability of needs, not just the volume of care required.
action
Kent's high population aged 65+ means CHC is common here. Clinicians will be experienced with older populations and complex, multi-domain needs. Build your evidence using the DST's 12-domain framework — show how the person's needs interact across physical health, cognition, behaviour, and continence, not just individual diagnoses.
action
Use the largest teaching trusts to your advantage: East Kent Hospitals (William Harvey, Kent and Canterbury) and Medway Maritime are high-volume acute trusts with discharge teams experienced in pre-discharge CHC screening. Ask for a comprehensive CHC Checklist before any hospital discharge.
action
Rural Kent families should document geographic barriers — distance to specialist services, care agency reluctance to serve remote villages. This strengthens arguments about healthcare complexity beyond what can be managed locally.
action
If local authority social care involvement in the assessment feels like pressure to categorise your case as "social care," escalate concerns to the CHC team and ask for a written statement on how the health vs social care boundary is being applied in your case.
Hospital trusts in Kent and Medway
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.
East Kent Hospitals University NHS Foundation Trust
William Harvey Hospital (Ashford), Kent and Canterbury Hospital, Queen Elizabeth Hospital (Margate)
Medway NHS Foundation Trust
Medway Maritime Hospital (Gillingham)
Maidstone and Tunbridge Wells NHS Trust
Maidstone Hospital, Tunbridge Wells Hospital, Mid Sussex services
Dartford & Gravesham NHS Trust
Darent Valley Hospital
Contact Kent and Medway
Phone
01634 335095Website
Visit website →Address
NHS Kent and Medway ICB, 2nd Floor Gail House, Lower Stone Street, Maidstone ME15 6NB
Frequently asked questions
Why is Kent's social care system under such pressure, and how does this affect CHC?
Kent's local authority faces severe adult social care funding shortfalls (£30+ million annually) while the population ages rapidly — 20% are 65+ today, projected to rise 30% by 2035. This means social care packages are increasingly unavailable or restricted. While this creates pressure on CHC to fill gaps, the NHS cannot use CHC as a substitute for social care. However, it does mean your case is being assessed in a context of acute system stress — emphasize the healthcare complexity and unpredictability of your loved one's needs, not just the volume of care required.
How can I request a CHC assessment in Kent and Medway?
Contact your GP, hospital ward, or the ICB directly on 01634 335095 or Kmicb.generalenquiries@nhs.net. Request a CHC Checklist screening — you don't need a referral, and anyone (the person needing care, family member, or care home manager) can make the request. If the person is in hospital, ask the discharge team to complete a Checklist before discharge.
My relative is being discharged from a Kent hospital. What should I do?
Contact the discharge team immediately and explicitly ask: 'Should my relative have a CHC Checklist screening before discharge?' Kent's hospitals are under capacity pressure, so you may need to be proactive. Ask for a written response if the team says CHC doesn't apply — document this for future appeals. If discharge is imminent and no Checklist has been completed, escalate to the hospital's patient advocacy team.
Can I use the social care funding crisis as part of my CHC advocacy?
Not directly. The NHS won't approve CHC simply because social care is unavailable. However, if social care unavailability contributes to unmanaged health risks (e.g. untreated pressure sores, missed medications, falls from lack of mobility support), this points to healthcare complexity and unmet health needs — which is a legitimate basis for CHC. Frame the argument around healthcare impacts, not social care shortfalls.