MidlandsICB

Why Shropshire, Telford and Wrekin Approves Only 5.9% of CHC Applications

Shropshire, Telford and Wrekin spans 1,347 square miles serving 500,000 people across a stark urban-rural divide: affluent rural Shropshire (25% aged 65+) contrasts sharply with deprived urban Telford (ranked in the top 30% most deprived English areas). Being on the Wales-England border, the ICB also serves Welsh residents, creating complex CHC funding responsibility questions and limited specialist services.

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

5.9%

Approval rate 2024/25

19.5%

National average

1 / 36

England rank

Approval rate 2024/25

5.9%

National avg: 19.5%

England rank

1 / 36

1 = lowest approval rate

CHC team contact

stw.icbindividualcommissioning@nhs.net

0300 123 1461

Understanding CHC in Shropshire, Telford and Wrekin

This area presents profound health inequality. Shropshire is relatively affluent and rural with an aging population; Telford is urban, young by comparison, and characterized by multiple deprivation drivers: food poverty, limited employment, and historically lower health literacy. For CHC purposes, this translates to very different demand patterns: rural Shropshire sees predominantly older adults with long-term conditions (COPD, heart disease, dementia), while Telford's CHC cases are more likely to involve younger adults with mental health needs, acquired brain injury, or neurodevelopmental conditions. The ICB's CHC team must manage both—a significant operational challenge with limited resources.

Shropshire's age profile (25.3% aged 65+) is a key driver of CHC referrals; many family carers are themselves elderly and unable to sustain care without funded support. Conversely, Telford's deprivation means access to private care is minimal, and families are wholly dependent on NHS-funded provision. Food poverty in Telford is significantly above the England average, affecting health outcomes and complicating CHC discussions: families may argue that nutrition-related conditions warrant CHC, but the ICB may classify this as social care territory (food bank access, housing support).

The Wales-England border creates unique complexity. Residents on the Welsh side of the border who use English NHS services (particularly the Royal Shrewsbury Hospital) may have CHC eligibility disputes: Is English NHS responsible, or Welsh Health Board? These cases are frequently disputed and require escalation. Additionally, the ICB provides some specialist orthopaedic services (Robert Jones and Agnes Hunt Hospital) that draw referrals from mid-Wales, further complicating boundaries and funding responsibility. Families here must confirm CHC eligibility and funding responsibility in writing before assessment begins.

CHC approval statistics for Shropshire, Telford and Wrekin

Source: NHS England official CHC statistics, 2024/25 · Rank 1 of 36 ICBs in England

Below national average(-13.6pp vs national avg)

Standard approval rate

5.9%

National avg: 19.5%

Assessments completed

493

29 found eligible

Fast-track approved

1,622

of 1,622 fast-track assessments

Local review requests

12

33.3% changed to eligible

Currently receiving CHC

423

Snapshot Q3 2025/26

England rank

1 / 36

1 = lowest approval rate

How Shropshire, Telford and Wrekin compares — 2024/25

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

Three-year approval rate trend

2022/23
9.9%
2023/24
9.4%
2024/25 (latest)
5.9%

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

What this means

Shropshire, Telford and Wrekin approves 5.9% of standard CHC applications — 13.6 percentage points below the national average of 19.5%. Research by the Nuffield Trust shows this variation is driven by how ICBs apply the National Framework, not by differences in clinical need. If you have been refused CHC here, the quality of your evidence presentation and a robust Local Review challenge are your strongest levers.

How to apply for CHC funding in Shropshire, Telford and Wrekin

NHS Continuing Healthcare (CHC) is assessed and funded by your local Integrated Care Board. If you live in the Shropshire, Telford and Wrekinarea, 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 Shropshire, Telford and Wrekin CHC team on 0300 123 1461 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 Shropshire, Telford and Wrekin

These tips are specific to applying for CHC in the Shropshire, Telford and Wrekin area.

action

If you live in rural Shropshire and have difficulty attending hospital appointments, request home-based assessment or use the Royal Shrewsbury Hospital as your primary assessment site; geographic barriers are valid adjustment requests.

action

If you live in Telford and are on a low income, escalate to Healthwatch or your local council's CHC champion if the ICB suggests that social care (food bank, housing support) can substitute for health care funding—this is a common boundary dispute.

action

If you live on the Wales side of the England-Wales border, confirm in writing with the ICB whether your CHC will be funded by England (NHS) or Wales (Health Board) before assessment begins; do not let assessment proceed under ambiguous funding responsibility.

action

For relatives with orthopaedic or specialist surgical conditions, ensure the assessment team is aware of your tie to the Robert Jones and Agnes Hunt Hospital; some specialist commissioning is done separately from mainstream CHC.

action

In Telford, use local foodbanks and housing support services alongside your CHC application—independent evidence of social care insufficiency strengthens your primary health need argument.

Hospital trusts in Shropshire, Telford and Wrekin

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.

Shrewsbury and Telford Hospital NHS Trust

Royal Shrewsbury Hospital, Princess Royal Hospital

Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust

Shropshire Community Health NHS Trust

Contact Shropshire, Telford and Wrekin

Address

NHS Shropshire, Telford and Wrekin, Unit 3, Lakeside Business Park, Broadway, Worcestershire, WR10 3UJ

Visit the official Shropshire, Telford and Wrekin CHC page →

Frequently asked questions

I live on the Welsh side of the border and use the Royal Shrewsbury Hospital. Who funds my CHC?

This depends on your usual place of residence and which health board you are registered with. Contact the Shropshire, Telford and Wrekin ICB (stw.icbindividualcommissioning@nhs.net) and your Welsh Health Board in writing before assessment to confirm funding responsibility. Do not proceed with assessment until this is clarified in writing.

I live in Telford and am struggling with food poverty. Can this be part of my CHC case?

Food poverty is typically social care territory, not health care. However, if malnutrition is directly causing or worsening your health condition (e.g., diabetic complications, weakness exacerbating mobility loss), this must be documented by a healthcare professional and explicitly linked to your health need. The ICB must demonstrate why NHS-funded care is necessary beyond social support.

Are there specialist assessments for orthopaedic or surgical conditions?

Yes. The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust has separate commissioning arrangements. If your CHC case involves ongoing orthopedic care or rehabilitation, ensure your GP refers you to the specialist commissioning pathway, not routine CHC.

What support is available if I am a care-giver aged 65+ in rural Shropshire?

Your age and carer status should be explicitly documented in the CHC assessment. You may also be eligible for a separate Carer's Assessment through Shropshire County Council, which can support respite care or carer funding. Contact the council's adult social care team for details.

Official resources

CHC funding support for families in Shropshire, Telford and Wrekin

Unsure whether your case qualifies?

CareAdvocate helps families prepare NHS Continuing Healthcare applications in the Shropshire, Telford and Wrekin 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