Completing a CHC Checklist Assessment
If you’re currently exploring NHS Continuing Healthcare (CHC) funding for a relative, the CHC Checklist is the first formal step in the process. It’s a short screening tool designed to identify whether someone might need a full CHC assessment.
The Checklist itself doesn’t decide who receives CHC funding but helps health and social care professionals determine whether your relative’s needs are high enough to justify a full assessment. If the Checklist is positive, the Integrated Care Board (ICB) should arrange a full CHC assessment within 28 days.
You can find more information about the process in our Continuing Healthcare and CHC Checklist assessment guides.
In this article:
What is a CHC Checklist?
The CHC Checklist is a national screening tool used to identify individuals who may be eligible for CHC funding. It helps decide whether someone should go forward for a full assessment using the Decision Support Tool (DST).
The Checklist is divided into several care domains, including but not limited to:
- Breathing
- Nutrition
- Continence
- Mobility
- Skin integrity
- Cognition
- Communication
- Behaviour
- Psychological & Emotional needs
Each domain helps professionals understand the nature, intensity, complexity and unpredictability of a person’s needs. When completing the checklist, the assessor selects a score in each domain:
- A – High level of need
- B – Moderate level of need
- C – Low or no level of need
The pattern of As, Bs and Cs determines whether the person requires a full assessment. It’s important to remember that a well-managed need is still a need, and the assessor shouldn’t reduce scores simply because care is in place. If the threshold is met, the person should move on to the full assessment of eligibility stage.
Example of a completed CHC Checklist
Families often ask to see an example of a completed CHC Checklist so they can better understand how the tool should look. A properly completed checklist should include:
- Scores of A, B or C for each domain
- Short, clear notes describing the person’s needs
- References to supporting evidence i.e. care records or medical notes
- A recommendation for next steps
Once completed, the assessor signs and dates the document, includes their job title, and records who attended the assessment, i.e. family members or representatives.
You are entitled to receive a copy of the completed checklist. It’s an important document that forms part of your relative’s CHC record and can help if you later request a review or re-assessment.
A positive checklist doesn’t guarantee CHC funding; it simply triggers the next stage of the process (the full CHC assessment), which looks at needs in more detail before a decision is made by the ICB.
We’ve put together an example of what a completed CHC Checklist should look like:
Who can complete a CHC checklist?
The Checklist can be completed by trained professionals in either health or social care, and could include:
- A social worker
- A registered nurse or nurse practitioner
- A GP or hospital doctor
- Other professionals with appropriate CHC training
Can nurse practitioners complete a CHC Checklist?
Yes, nurse practitioners are fully qualified to complete a checklist, as long as they are trained in the CHC process and understand how to apply the national guidance.
Family members and representatives also have the right to be involved. You should be told when the Checklist is being carried out, invited to attend and encouraged to share your own view of your relative’s needs.
Farley Dwek’s Checklist Support Service allows our qualified CHC Nurse Assessor to review your relative’s situation in advance, so they can help identify your relative’s needs, provide skilled advocacy at the assessment and ensure relevant evidence is considered.
When should a CHC Checklist be completed?
A CHC Checklist should be completed whenever it appears that a person may meet the criteria for Continuing Healthcare funding. Common situations include:
- When being discharged from hospital requiring an increased level of care
- When being admitted into a nursing home
- When there has been a significant deterioration in health
- When there’s uncertainty about who should fund care
The Checklist is usually completed after hospital discharge, once the person’s condition has stabilised, ensuring that the assessment reflects their long-term needs, and not just their recovery from an acute episode.
You don’t need to wait until a person’s savings are depleted before requesting a checklist -it’s based purely on care needs, not financial circumstances.
What happens once the Checklist is completed?
Once the Checklist is finished, you should receive:
- A written outcome confirming whether your relative has “screened in” or “screened out”
- A copy of the completed checklist showing the scores and assessor’s notes
If the Checklist is positive, the ICB must:
- Treat it as a referral for a full CHC assessment
- Appoint a CHC co-ordinator
- Arrange for a multidisciplinary team (MDT) to complete the Decision Support Tool (DST) within 28 days
If the Checklist is negative, your relative will not move forward to a full assessment. In that case:
- Care is usually arranged by the local authority and means-tested
- The person may still qualify for NHS Funded Nursing Care (FNC) if they’re in a nursing home
- You can ask the ICB to review or reconsider the decision if you disagree
There’s no fixed rule for how long you must wait before requesting another checklist. If your relative’s condition changes or deteriorates, you can ask for a new assessment at any time.
Can you appeal the CHC Checklist decision?
There’s no formal appeal process at the Checklist stage, as appeals apply only after a full CHC assessment. However, you can still:
- Ask the Integrated Care Board to review the Checklist outcome
- Provide additional evidence for the ICB to reconsider the decision
- Request a new checklist if there’s a change in condition
- Use the NHS complaints procedure if you feel the process was handled incorrectly
If the ICB later carries out a full assessment and decides your relative is not eligible for CHC, you can then use the official CHC appeals process to challenge that decision.
In urgent or end-of-life situations, you may also be able to use the Fast Track Pathway, which allows CHC funding to be approved quickly without completing a checklist.
Read more about next steps in our guide to the CHC full assessment.
Speak to Farley Dwek
Understanding the CHC process can be daunting, especially when you’re caring for a loved one with complex health needs. Our specialist team can help you through every stage. At Farley Dwek, we:
- Review your relative’s case and explain the process to you
- Help prepare supporting evidence before the assessment
- Offer skilled advocacy at the Checklist by an experienced CHC Nurse Assessor
- Provide expert advice if the ICB’s decision is unfair or incomplete
To speak to one of our specialists, please contact us or visit our Continuing Healthcare page for more guidance.