The CHC Checklist

The Continuing Healthcare (CHC) Checklist

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

If you ‘pass’ the Checklist stage, you should be referred for a Full CHC Assessment.

You can download a blank CHC Checklist from the gov.uk site.

When should a CHC Checklist be completed?

Completion of a CHC 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 (NB. changes to hospital discharge due to COVID mean that Checklists are currently completed after discharge)
  • 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 a Checklist 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.

Occasionally, individuals are referred straight for a Full Assessment – skipping the Checklist stage.

What is the CHC 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 11 domains (areas) of care: breathing, nutrition, continence, skin integrity, mobility, communication, psychological/emotional, cognition, behaviour, symptom control, altered states of consciousness.

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.

You should be able to find contact details for your local ICB 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 ICB:

  • 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 Integrated Care Board (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.

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