Patients in the Black Country have the highest rate of eligibility for NHS Continuing Healthcare (CHC) funding across England, according to recent figures. The data reveals that Black Country patients are nearly five times more likely to receive full NHS CHC funding than those in the nearby Birmingham and Solihull area.
Regional differences in eligibility rates
The CHC scheme covers the full cost of care for adults with significant, ongoing healthcare needs and is funded entirely by the NHS, regardless of personal finances. Recent figures show stark regional differences in eligibility rates across the country.
In the Black Country, 457 out of 1,082 patients (42.2 per cent) assessed in 2025/26 were deemed eligible for CHC funding. This contrasts sharply with the Birmingham and Solihull ICB area, where only 106 of 1,141 patients (9.3 per cent) qualified.
Postcode lottery concerns
James Urquhart-Burton, head of continuing healthcare claims at Winston Solicitors, said: "Everybody’s well aware that there are regional differences between eligibility rates around the country, to the extent that it’s long been referred to as a postcode lottery.
"Of course, there will be legitimate differences between the different areas because populations and their health needs differ, but a system that produces a 42 per cent success rate in one ICB and less than 6 per cent in another demands proper investigation and explanation."
National average and lowest rate
The national average eligibility rate stands at 17.4 per cent. The Black Country ICB recorded the highest rate in England, while Gloucestershire ICB had the lowest at just 5.6 per cent.
Mr Urquhart-Burton said: "For those whose loved ones are being assessed, these figures aren’t just abstract statistics. Being eligible for Continuing Healthcare can lead to the NHS meeting the full cost of someone’s care rather than them or their families potentially having to fund the substantial care costs themselves.
"Patients should be able to trust that comparable needs will lead to comparable decisions, wherever they live. To achieve that level of trust, the ICB’s responsible for CHC decisions need to explain what is driving these enormous variations, while NHS England should ensure that significant outliers are properly investigated and understood."
Coverage areas and eligibility criteria
The Black Country ICB covers Dudley, Sandwell, Walsall and Wolverhampton, while the Birmingham and Solihull ICB covers Birmingham and the neighbouring borough of Solihull. CHC funding applies to adults aged 18 and over and is not means-tested.
