Continuing Healthcare (CHC) | The checklist

The Continuing Healthcare (CHC) checklist is the first step to find out if you are eligible for NHS Continuing Healthcare funding.  

NHS Continuing healthcare is not means tested and is a fully funded package of care that some people are entitled to.  To qualify for Continuing Healthcare funding, you must have a ‘primary health need’.  

This is not determined by the care setting you may live in, nor is it based on your diagnosis.  It is determined by the level of care intervention required to meet your care needs.  A ‘primary health need’ is defined by your needs being more weighted towards ‘health’ rather than social care needs.

Eligibility for CHC funding is a two-stage assessment process:

Stage 1 - The checklist:  the aim is to get a general indication of your level of health needs and the threshold for passing to the next stage is quite low.

Stage 2 - The full assessment:  If you “pass” the checklist, a full assessment known as a ‘Decision Support Tool’ document is completed at a meeting involving family members/representatives and health and social care professionals.

What are the 12 key areas/domains used for CHC?

The checklist considers 12 key areas (known as domains) which have scoring options of A, B and C.

1. Areas where there are high levels of care needs
2. Areas where there are moderate levels of care needs
3. Areas where there are low or no needs

The health domains are:

• Breathing
• Nutrition
• Continence
• Skin
• Mobility
• Communication
• Psychological and emotional needs
• Cognition
• Behaviour
• Drug therapies and medication 
• Altered states of consciousness (ASC)
• Other significant needs.

How do I get continuing healthcare (CHC) funding?

This will be determined by the scores you get under the 12 health domains:

If you have the following results, you MAY qualify for CHC funding:

Two or more A’s
Five or more B’s
One A and four Bs

There are also 4 domains where a score of ‘A*’ means a full assessment will be carried out regardless of the scores in the other domains.  These are:

•    Behaviour
•    Breathing
•    Drug and symptom control
•    Altered states of consciousness

Click here to download a blank CHC checklist from the gov.uk website.

Who can complete the checklist?

Who completes the checklist depends on where the care is being delivered.

• If you live at home or in a residential care home, a district nurse, social worker or another health professional who is involved in your care and who is appropriately trained can complete the checklist
• If you are receiving care in a nursing home, a registered nurse at the home can complete the checklist. 

When should the checklist be completed?

A checklist should be considered in the following situations:

• When you are moving into a care home where nursing care will be provided, and before you receive an assessment for funded nurse care (FNC) https://www.moore-tibbits.co.uk/news/funded-nursing-care-rate-to-increase/
• Following discharge from hospital, and after a period of recovery and/or rehabilitation. If there has been a significant change or increase in the level of care you require

Whilst professionals will often instigate a checklist, if this does not happen, it is important that you are proactive in requesting the checklist is completed.  Often, if a person is paying privately for care and the local authority is not involved, the completion of a checklist is overlooked.

If it is being proposed that your package of care should be increased or that your needs can no longer be met at home, it is most likely that an updated assessment of needs should be completed by the local authority regardless of whether they will be funding the care.  As part of that assessment, a social worker would then consider whether a checklist should be completed.

Checklists should generally be undertaken when a person’s care needs are most understood.  If a person is being discharged from hospital, the checklist usually would not be undertaken in the hospital setting but once they have been discharged from hospital.  Again, if you are paying privately for your care, it would be prudent to ask who will ensure the checklist is completed before you are discharged from hospital.

If you believe a checklist should be undertaken, you are entitled to ask for one at any time.  Not all health professionals have a full understanding of the checklist so do not be put off and if there is reluctance to complete one, you can contact your local Integrated Care board (ICB) directly to request that a checklist be completed.

What happens after the checklist has been completed?

The clinician completing the checklist should inform you and/or your representative of the outcome.  If the checklist is positive and therefore a more in-depth assessment of your needs is required, the clinician will submit the checklist to the Integrated Care Board (ICB) and a date for the assessment will be sent to you.

Whatever the outcome of the checklist, the ICB should notify you by letter as soon as is reasonably practicable.  Should you disagree with the checklist outcome you can ask the ICB to reconsider the decision via the ICB complaints procedure.

Further help…

You should not need to instruct a solicitor to get a checklist completed.  If you are experiencing problems, we would recommend contacting your local MP or lodging a formal complaint.

If you still have questions regarding the checklist, we provide a CHC Triage service (please click here for further details).