The CHC Checklist
The Continuing Healthcare (CHC) 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.
Click here to download a blank CHC Checklist from the gov.uk site.
When should a CHC Checklist be completed?
There are no absolute rules as to when a Continuing Healthcare Checklist should be triggered, however it is important that they are completed at the right time, in the right location and when the individual’s care needs are better understood. Checklists should not be completed in acute settings (hospital) unless there are exceptional reasons to do so, and should normally completed once the individual has been discharged from hospital.
A Checklist should usually be triggered in the following circumstances:
- when the individual is going into a care home with nursing and before receiving an NHS Funded Nursing Care (FNC) assessment
- where the individual has significant ongoing care needs
- 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 CHC Checklist is the first step 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 12 domains (areas) of care: breathing, nutrition, continence, skin, mobility, communication, psychological and emotional needs, cognition, behaviour, drug therapies and medication, altered states of consciousness and other significant care needs.
These are the same care domains as in the form used in the full assessment, called theDecision Support Tool (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.
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.
To find out more about this first step in the assessment process, read The Essential Guide to getting assessed for NHS Continuing Healthcare funding.
For detailed written information about all stages of the NHS CHC process, register for our Free Navigational Toolkit.