Full Assessment

The full assessment will be completed by a multidisciplinary team, many of whom hold roles relevant to the type of care or health needs of the individual undergoing assessment, and in most cases this team will comprise of health and social care professionals who have been directly involved in delivering the individual’s care. It is also recommended that any health or social care professionals involved in providing care for the individual in question are asked for input into the assessment. In some cases, they may even be asked to provide detailed specialist assessments.

The multidisciplinary team will be coordinated by a representative of the Clinical Commissioning Group (the coordinating assessor) who will use a Decision Support Tool to help the team understand the totality of the individual’s health and social care needs, as well as the care required to meet those needs. The Decision Support Tool enables the team to organise these needs into 12 areas, referred to as domains. These domains include behaviour, cognition, nutrition and continence, amongst others. In order to assess the severity of a particular area of need, the team will populate each domain with appropriate evidence, often taken from the individual’s recent care records as well as a face-to-face meeting involving the individual or their representative. The multidisciplinary team will then use this evidence to assign a level of need ranging from ‘No Needs’ to ‘Priority’, depending on the severity of that need. For example, in the behaviour domain, if an individual is fully compliant with their care they may be assessed as having ‘No Needs’, whereas an individual who presents with challenging or aggressive behaviour on a regular basis may be assessed as having a ‘Moderate’, ‘High’ or even ‘Severe’ need. Each level of need has a descriptor to help the team identify the correct level to apply.

When all 12 domains have been populated, the multidisciplinary team must decide whether the individual has sufficiently intense, complex or unpredictable needs, as well as considering the nature of these needs. At the completion of the assessment the multidisciplinary team will make a recommendation to the CCG as to whether there is a primary health need and therefore, if the individual is eligible for NHS continuing healthcare. The CCG will then make a final decision which must uphold the recommendation of the multidisciplinary team in all but exceptional circumstances. If the individual is successful, NHS continuing healthcare funding will be awarded and paid from the 29th day after the positive Checklist assessment was received by the CCG. The individual’s eligibility status (and therefore funding status) will be reviewed after three months to ensure all health needs are being met and that the individual is still eligible, and after this the funding will be subject to annual reviews. For detailed information about the assessment process, please download or request a copy of our Navigational Toolkit.