Continuing Care Explained: What It Means for Foster Carers in England

If you have been reading up on fostering, you have probably met the phrase “continuing care”. It sounds self-explanatory, and then turns out to mean two different things depending on which part of the UK you are in. One is about a child’s health. The other is about a young person staying on with their carer after they stop being looked after, and belongs to Scottish law. Here is which is which, and where you fit in.

Please note: this is general information about how continuing care works in England, correct at 27 August 2026, not advice about any individual child. Eligibility is decided by the local integrated care board, not by a fostering agency, and the rules sit in the National Framework for Children and Young People’s Continuing Care (Department of Health, revised 2016). For a particular child, speak to their social worker and your supervising social worker.

Two different things, one name

In England, continuing care is a health thing: an NHS-funded package of support for a child under 18 whose needs arise from disability, accident or illness and cannot be met by the services already available to them. In Scotland, Continuing Care with a capital C is something else, a right for a young person to carry on living with their carer after they cease to be looked after, set out in Part 11 of the Children and Young People (Scotland) Act 2014. The two share a name and almost nothing else.

If you foster in London, the Scottish arrangement will not apply to you. We mention it only because much of what comes up online about continuing care is written for Scotland, and carers reasonably assume it applies everywhere. The English equivalent of staying on with your foster family past 18 is Staying Put, which works rather differently.

What continuing care means in England

NHS children and young people’s continuing care is a package of health support funded by the NHS for a child up to their eighteenth birthday, for situations where ordinary universal services and the usual specialist input are not enough. Responsibility sits with the local integrated care board, which took over from clinical commissioning groups in July 2022. It is not a benefit you apply for on a form, and it is not an Education, Health and Care plan, although plenty of children have both. In practice a package might look like:

• Waking night or overnight nursing support so someone is awake to manage a child’s breathing or seizures
• Trained help with feeding through a tube, or with suction and oxygen
• Funded care hours each week from a health care worker
• Specialist equipment, and training to use it safely

None of it changes who the child lives with. What changes is that part of the support around them is organised by the NHS rather than children’s services, and a health assessor becomes one more person at the table.

How the assessment works

The process is more structured than people expect, which helps when you are the one asking. A referral goes to the integrated care board, usually from a paediatrician, a community nurse or the child’s social worker. A nominated health assessor then builds a picture of the child from health reports, the child’s own views, and what the people who look after them day to day actually see. That last part is you. The assessor scores the child across ten areas using a decision support tool:

• Breathing
• Eating and drinking
• Mobility
• Continence and elimination
• Skin and tissue viability
• Communication
• Drug therapies and medicines
• Psychological and emotional needs
• Seizures
• Challenging behaviour

Each area is rated from no additional needs up to severe or priority. A child is likely to have a continuing care need if they come out at the very top of that scale in one area, or high in several, but no single score decides it. The recommendation then goes to a multi-agency forum, where health, education and social care look at it together. The framework expects a decision within six weeks of the assessment starting, and packages are reviewed as the child grows.

Where you come in

This is the part carers underestimate. An assessor sees a child for an hour or two. You see them at three in the morning, on the school run, on a bad day in a supermarket car park. Your recording is not paperwork for its own sake here, it is evidence, and a dated log of how many times a night you were up or how long a feed took is often what makes a package land at the right level. Vague notes lose children support they should have had. While an assessment is live:

• Record care tasks and how long each takes, rather than general impressions
• Ask to be at the meetings, and ask for the decision in writing with the reasons
• Be clear about what you can safely do and what you cannot, before a package is built on an assumption
• Ask what training comes with any clinical task, and who signs off that you are competent
• Ask when the review is, and diarise it yourself

Saying “I cannot manage that overnight without help” is not a failure. Carers who say it early usually end up with a better package than carers who quietly cope until they cannot. If you are considering fostering a child with a disability or additional needs, that is the honest picture: the support exists, but somebody has to ask for it properly.

What happens when they turn 18

Continuing care stops at 18. What replaces it, if anything, is adult NHS Continuing Healthcare, which runs on a different framework with a noticeably higher bar (last revised July 2022, corrected July 2023). Some young people who had a substantial package as children do not meet the adult test, and their support moves to adult social care under the Care Act 2014 instead. Better to have that conversation early. The timings are set nationally:

• Transition planning should begin at 14
• Screening against the adult tools happens at 16 or 17
• An eligibility decision should be made by 17, so nothing falls over on their eighteenth birthday

If a young person you care for is 13 or 14 and nobody has mentioned transition, ask. That one question, put to their social worker in a supervision meeting, has saved families a very stressful year. It sits alongside the wider work of getting a young person ready for independence, which starts long before anyone packs a bag.

And if they want to stay living with you?

In England that is Staying Put, not continuing care. It comes from section 23CZA of the Children Act 1989 and puts a duty on the local authority to support the arrangement until the young person turns 21. Be warned that the money changes: a Staying Put payment is agreed with the council and is generally lower than a fostering fee, because the young person is now an adult who may be working or claiming in their own right. Plenty of carers do it anyway and call it the most obvious decision they ever made. Alongside it, every care leaver has a personal adviser up to 25 under the Children and Social Work Act 2017, and the Children’s Wellbeing and Schools Act 2026 added a duty on councils to provide Staying Close support up to 25 where a care leaver’s welfare requires it. That duty is being commenced in stages, so what is on offer in a given borough depends on how far the council has got.

You won’t have to do this alone

Nobody expects a foster carer to arrive understanding integrated care boards, decision support tools and transition protocols. That is what the team around you is for. Every GLF household has a supervising social worker who knows the child, knows the process and will sit in the meetings with you, and someone is on the end of the phone out of hours when something happens at nine on a Sunday evening. We will push for a proper assessment when we think a package has been set too low. Ofsted inspected us between 21 and 25 July 2025 and rated GLF Outstanding in all three judgements, and the support we wrap around every household is a large part of why.

On money, so you are not left guessing: GLF pays £479.50 a week for a child under 11 and £507.50 a week for a child aged 11 or over, per child and while they are placed with you. Where a child’s needs are higher, an enhanced fee of roughly £100 to £200 a week more may apply. That is one weekly fee covering the allowance and your reward, and you can read how foster carer pay works in more detail. A child’s NHS continuing care package is separate, and funds health support for them rather than your fee.

It is completely normal to read all of this and think it sounds like a lot. Most carers find it far less daunting once the person beside them has done it thirty times before.

Frequently asked questions

Is continuing care the same as Staying Put?

No. In England, continuing care is NHS-funded health support for a child under 18 with complex needs arising from disability, accident or illness. Staying Put lets a young person carry on living with their foster family after 18, up to the age of 21. People mix them up because in Scotland the phrase Continuing Care is used for the staying-on arrangement, so a lot of online information about it does not apply in England.

Do I need a nursing background to foster a child with continuing care needs?

No. Most carers looking after children with continuing care packages have no clinical background at all. Where a task such as tube feeding or emergency medication is needed, you are trained and assessed as competent first, with a written plan for what to do if something goes wrong. If you are not confident, say so. That is information the assessment needs, not a mark against you.

Does an NHS continuing care package change what I get paid?

Not directly. Continuing care funding buys health support for the child and is arranged by the integrated care board. Your fostering payment is a separate agreement with your agency. At GLF that is £479.50 a week for a child under 11 and £507.50 for a child aged 11 or over, with an enhanced fee of around £100 to £200 a week more where needs are higher.

How long does a continuing care decision take?

The national framework expects a decision within six weeks of the assessment starting, though it allows flexibility where a longer look is in the child’s interests. If it drifts well beyond that with no explanation, ask your supervising social worker to chase it in writing.