The CHC Checklist

The CHC Checklist

Step 1 of the NHS Continuing Healthcare assessment process

The first step to find out if you are eligible for NHS Continuing Healthcare (CHC) is to have an initial assessment using a form called the Continuing Healthcare Checklist. This is conducted by a nurse, doctor, social worker or other qualified healthcare professional, who carries out a brief evaluation of your care needs.

You can download a blank CHC Checklist here.

When should a CHC Checklist be completed?

There are no absolute rules as to when a Continuing Healthcare Checklist should be triggered, however it is important that they are completed at the right time, in the right location and when the individual’s care needs are better understood. Checklists should not be completed in acute settings (hospital) unless there are exceptional reasons to do so, and should normally completed once the individual has been discharged from hospital.

A Checklist should usually be triggered in the following circumstances:

  • when the individual is going into a care home with nursing and before receiving an NHS Funded Nursing Care (FNC) assessment
  • where the individual has significant ongoing care needs
  • when an individual’s physical or mental health appears to decline significantly

However, you can seek an assessment at any time. Any health and social care professional who has been trained to do so should be able to complete a Checklist, including GPs, social workers, and district nurses.

What is the Continuing Healthcare Checklist?

The Checklist is the first step of paperwork in the NHS Continuing Healthcare process. It’s a tool to help health and social care professionals rapidly assess whether an individual should proceed to have a Full Assessment.

The Checklist considers 12 domains (areas) of care:

  • Behaviour
  • Continence
  • Cognition
  • Skin and tissue viability
  • Psychological and emotional needs
  • Breathing
  • Communication
  • Drug therapies and medication
  • Mobility
  • Altered states of consciousness
  • Nutrition – food and drink
  • Other significant care needs

These are the same care domains as in the form used in the full assessment, called the Decision Support Tool (or DST), but the scoring options are simpler than in the DST: just A, B or C.

A is assigned to areas in which there are a high level of care needs. B is assigned to areas in which there are a moderate level of care needs. C is assigned to areas in which there are low or no needs. You can read full descriptions of what these levels mean for each area on the Checklist form.

Many health and social care professionals are trained and qualified to complete the Checklist – including GPs, social workers, district nurses and care home nurses. However, many professionals do not have a good understanding of the procedures or how to apply the Checklist correctly.

Don’t be put off if your health professional thinks you are wasting your time. You have a right to a request a Checklist assessment and you can request one directly from your local Integrated Care Board (ICB) if you wish.

Find contact details for your local ICB.

What score do I need to be offered a Full Assessment?

The Checklist scoring threshold is set intentionally low; it aims to screen people in rather than out. A full assessment is required if you are assessed with any of the following:

  • Two or more As
  • Five or more Bs
  • One A and four Bs
  • An A in any of these areas: behaviour, breathing, symptom control, altered states of consciousness

You do not always have to meet these criteria, some people might be offered an assessment with (for instance) four Bs. It’s at the discretion of your ICB, who are in charge of CHC in your area.

If the Checklist rules out a Full Assessment, no further action will be taken. However, if you disagree with the Checklist result, or you don’t think it was carried out correctly, you can ask the ICB to reconsider the decision.

More information about the Checklist

To find out more about this first step in the assessment process, read Part 1 of our Essential guide to getting assessed for NHS Continuing Healthcare

For detailed written information about all stages of the NHS CHC process, register for our Free Navigational Toolkit.