CHC approval rates for every ICB in England

The share of people assessed through the standard NHS Continuing Healthcare route who were found eligible, in the 12 months to June 2026. Every ICB applies the same National Framework.

Source: NHS England quarterly CHC statistics (2026/27 Q1) · Updated 2026-08-14 · Methodology

17.7%

National average

5.0%

Lowest — Gloucestershire

27.8%

Highest — Greater Manchester

5.6×

Gap between them

The same legal test applies everywhere in England, so a gap this wide reflects how the National Framework is applied rather than differences in how ill people are. Research by the Nuffield Trust reaches the same conclusion. A low rate does not mean a case cannot succeed — it means the evidence has to do more work.

Rates below cover a full year to smooth out the reporting swings that make single quarters unreliable at ICB level. How we calculate this

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All 36 ICBs ranked

Lowest approval rate first. The dotted line marks the national average of 17.7%.

NHS Continuing Healthcare standard-route approval rates for all 36 Integrated Care Boards in England, 12 months to June 2026, ranked from lowest to highest.
#	Integrated Care Board	Approval rate	Assessed	Latest quarter
1	Gloucestershire	5.0%−12.7pp	544	2.6%
2	Surrey and Sussex	7.9%−9.8pp	3,125	6.7%
3	Shropshire, Telford and Wrekin	8.0%−9.7pp	600	11.3%
4	Birmingham and Solihull	8.2%−9.5pp	1,139	9.4%
5	South West London	8.9%−8.8pp	1,044	7.8%
6	Somerset	10.1%−7.6pp	862	11.1%
7	Coventry and Warwickshire	11.6%−6.1pp	1,015	10.5%
8	Dorset	11.7%−6.0pp	325	9.8%
9	Derby and Derbyshire	12.0%−5.7pp	855	9.5%
10	Herefordshire and Worcestershire	13.4%−4.3pp	1,325	13.3%
10	South Yorkshire	13.4%−4.3pp	1,610	15.8%
12	South East London	13.9%−3.8pp	787	15.4%
13	Bristol, North Somerset and South Gloucestershire	14.2%−3.5pp	1,304	14.5%
14	Kent and Medway	14.9%−2.8pp	1,132	9.3%
15	Bath and North East Somerset, Swindon and Wiltshire	15.0%−2.7pp	746	8.2%
15	Nottingham and Nottinghamshire	15.0%−2.7pp	1,539	15.0%
17	Norfolk and Suffolk	15.2%−2.5pp	1,615	12.6%
18	Cornwall and the Isles of Scilly	15.4%−2.3pp	397	19.8%
19	North East London	15.8%−1.9pp	752	20.9%
20	Devon	16.0%−1.7pp	2,040	17.9%
21	Thames Valley	16.3%−1.4pp	1,600	16.4%
22	West and North London	16.5%−1.2pp	2,090	13.5%
23	Staffordshire and Stoke-on-Trent	16.9%−0.8pp	1,084	17.9%
24	Northamptonshire	17.3%−0.4pp	1,076	19.2%
25	Humber and North Yorkshire	18.3%+0.6pp	1,186	16.9%
26	North East and North Cumbria	19.4%+1.7pp	3,555	21.0%
27	Cheshire and Merseyside	19.5%+1.8pp	3,164	16.7%
28	Hampshire and Isle of Wight	20.0%+2.3pp	1,705	24.5%
29	West Yorkshire	20.2%+2.5pp	1,992	23.5%
30	Lancashire and South Cumbria	21.1%+3.4pp	2,030	17.9%
31	Leicester, Leicestershire and Rutland	22.3%+4.6pp	1,091	24.0%
32	Lincolnshire	22.8%+5.1pp	851	26.8%
33	Central East	24.2%+6.5pp	2,464	22.0%
34	Greater Manchester	27.8%+10.1pp	1,430	28.8%
35	EssexQuarters vary by 31.4pp — treat with caution	34.3%+16.6pp	1,912	57.9%
36	Black CountryQuarters vary by 53.5pp — treat with caution	43.1%+25.4pp	1,087	19.8%

2 of the 36ICBs report quarters that disagree sharply with one another — a batch of decisions recorded in a single period can lift a whole year’s figure. Their rates are shown as published, but we do not name them as the highest or lowest in England, and neither should anyone quoting this table. Why this happens.

“Assessed” counts standard-route assessments completed in the 12 months to June 2026 (Jul–Sep 2025 to Apr–Jun 2026). Fast-track cases are excluded — NHS England records almost all of them as eligible, so including them would flatter every ICB equally and tell families nothing. Read the full methodology.

The rate tells you the odds. Your records tell you the case.

Approval rates describe averages across hundreds of assessments. What decides an individual case is whether the evidence in the care records is presented against the right domains. Our free screener walks you through where a case currently stands, in about five minutes.

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