NHS CHC | What is a Needs Portrayal Document?

When you are appealing an eligibility decision for continuing healthcare funding, it is crucial that medical evidence about the person’s needs is available.

A Needs Portrayal document is similar to the DST but differs in that it allows the ICB to collate information spanning several years.  The document has all relevant entries from the medical evidence in date order so it should reflect the person’s needs and how they may have changed over time.  The ICB will then prepare the Needs Portrayal document to assess a person’s eligibility for NHS continuing healthcare (CHC).

What if there are missing records

Unavailable, lost or damaged notes can mean the difference between someone being found eligible or not for NHS continuing healthcare (CHC).  Written evidence demonstrating the extent and level of an individual’s care needs are vital in the CHC assessment process, particularly in relation to appeals where often, a significant amount of time has passed since the original assessment.

We are able to challenge the ICB’s decision by forensically analysing the information that is available about the individual to complete a clinical ‘join-the-dots’ which, whilst time consuming, can ultimately prove successful in tackling the issue of missing information.

If care home records are not available, it is often very difficult to evidence the type and amount of care that an individual required on a day-to- day basis and whether the overall level of need met the test for eligibility in terms of the key characteristics of nature, intensity, complexity and unpredictability.  

As part of the appeal process, family members will be given an opportunity to provide a perspective of their relative’s needs.  This is crucial to help the assessor get a better understanding during periods where the records are unavailable.  However, if the records and the family’s views contradict each other, assessors will often base their decision on the evidence available so we cannot stress enough the importance of family diary entries etc. to help in these situations.

We advise you seek expert advice early on in the process to help challenge any inaccuracies and build a case for eligibility.