Initial Assessment: Checklist

Stage one of the NHS Continuing Healthcare assessment process

The first step to find out if you are eligible for NHS Continuing Healthcare is to have an initial assessment called a 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.

When should a Continuing Healthcare Checklist be completed?

Completion of a Continuing Healthcare Checklist should be triggered automatically in certain circumstances, such as:

  • when the individual is ready for discharge from hospital prior to a local authority funding assessment
  • when the individual is going into a care home with nursing before receiving an NHS Funded Nursing Care assessment
  • when an individual’s physical or mental health appears to decline significantly.

However, you can also 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.

NB. The information on this page refers to standard practice. During the coronavirus emergency, until 1 April 2022, the process was a bit different. If useful, you can find out more about the changes on our the COVID-19 pages that were written during the crisis.

What is the 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 covers 11 areas of care – including cognition, mobility, continence and breathing – against which the assessor marks you as having high, moderate or low/no needs. This is a short version of the Decision Support Tool used in Full Assessments.

You can download a blank CHC Checklist from the site.

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 Clinical Commissioning Group (CCG) if you wish.

You should be able to find contact details for your local CCG here.

What happens next?

The results of the Checklist should be communicated to you in writing as soon as possible.

The following results indicate that you have a chance of qualifying for CHC, and should trigger a Full Assessment for Continuing Healthcare, which is coordinated by your CCG:

  • Two As
  • Five Bs
  • One A and four Bs
  • One A*

However, a positive Checklist result is definitely no guarantee that CHC will be awarded. In fact, according to the National Audit Office fewer than one third of people who had a Full Assessment in 2015-16 were judged to be eligible.

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 CCG 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.