In July 2023, the High Court ruled in favour of the Commissioner for Older People for Northern Ireland, quashing the Department of Health’s Continuing Healthcare (CHC) policy on the grounds that it failed to properly consider its impact on older people. 

The case was brought by then Commissioner Eddie Lynch on behalf of Mr Robin McMinnis, a 75-year-old man with complex health needs. The Court found that his application for CHC had been handled unfairly and highlighted wider problems with how decisions were made about whether care should be treated as a health need (which is free under law) or as social care (which can be means-tested). 

In 2024, the Court of Appeal overturned parts of this ruling, finding that the 2010 CHC policy had been issued without proper legal authority and reinstating the Department’s 2021 policy. 

In June this year, the UK Supreme Court refused permission for a further appeal, meaning the Court of Appeal’s decision is now final. 

As a result, the 2021 policy remains in place. The Commissioner continues to have serious concerns about how this policy is applied and its impact on older people, and will continue to press for improvements to ensure fairness and transparency in the system. 

What is Continuing Healthcare (CHC)? 

CHC is a system used to decide whether a person’s needs are mainly healthcare or social care. 

  • Healthcare should always be free and provided by the health service. 
  • Social care (like help with washing, dressing, or eating) can be means-tested, meaning people may need to pay for some or all of it. 

Why did COPNI take a legal case about CHC? 
COPNI had concerns that: 

  • The 2010 CHC policy lacked clarity and fairness. 
  • The 2021 CHC policy introduced a single test that made it almost impossible for people with significant health needs to qualify for free care. 

The case was taken on behalf of Mr Robin McMinnis, who lives with complex health needs but was denied CHC and had to pay for his own care. 

What did the courts decide? 

  • High Court (2023): Found that the Belfast Trust had acted unfairly and irrationally in assessing Mr McMinnis’s needs, and that the Department had acted unlawfully by failing to issue promised guidance under its 2010 policy and had not properly complied with equality duties when adopting its 2021 policy. 
  • Court of Appeal (2024): Overturned parts of that decision, saying the 2010 policy was invalid and reinstating the 2021 policy. 
  • Supreme Court (2025): Refused COPNI’s appeal. This means the Court of Appeal’s ruling is final. 

What does this mean now? 

  • The 2010 policy can no longer be used. 
  • The 2021 CHC policy remains in force. 
  • This policy takes a very narrow view of healthcare needs. In practice, very few older people in Northern Ireland are likely to qualify for CHC, even if they have complex medical conditions. 

Is there any point in applying for CHC? 
Trusts will continue to use the 2021 policy. While you are entitled to ask for an assessment, most applications are likely to be refused under the current rules. If you are unsure, you can still contact our office for advice about your own situation. 

What is COPNI doing now? 
Although the legal case has ended, our work has not. COPNI will continue to press for a fairer and more transparent system, raise public and political awareness, and challenge the Department of Health on the way CHC is delivered. 

Where can I get advice? 
If you have questions about CHC or your own situation, please contact our legal and advocacy team on 028 9089 0892 or email info@copni.org.