The assessment process

Integrated Care Boards, known as ICBs (the NHS organisations that commission local health services), must assess you for NHS Continuing Healthcare if it seems that you may need it.

For most people, there’s an initial checklist assessment, which is used to decide if you need a full assessment. However, if you need care urgently – for example, if you’re terminally ill – your assessment may be fast-tracked.

  • Initial assessment for NHS CHC
    The initial checklist assessment can be completed by a nurse, doctor, other healthcare professional or social worker. You should be told that you’re being assessed, and be asked for your consent.

    Depending on the outcome of the checklist, you’ll either be told that you don’t meet the criteria for a full assessment of NHS CHC and are therefore not eligible, or you’ll be referred for a full assessment of eligibility.

    Being referred for a full assessment doesn’t necessarily mean you’ll be eligible for NHS CHC. The purpose of the checklist is to enable anyone who might be eligible to have the opportunity for a full assessment.

    The professional(s) completing the checklist should record in writing the reasons for their decision, and sign and date it. You should be given a copy of the completed checklist. You can download a blank copy of the NHS continuing healthcare checklist from GOV.UK.
  • Full assessment for NHS CHC
    Full assessments for NHS CHC are undertaken by a “multidisciplinary team” made up of a minimum of two health or care professionals who are already involved in your care. You should be informed who is co-ordinating the NHS CHC assessment. The team’s assessment will consider your areas of need, also referred to as NHS CHC Domains.

    If you have at least one priority need, or severe needs in at least two areas, you should be eligible for NHS CHC. You may also be eligible if you have a severe need in one area plus a number of other needs, or a number of high or moderate needs, depending on their nature, intensity, complexity or unpredictability.

    In all cases, the overall need, and interactions between needs, will be taken into account, together with evidence from risk assessments, in deciding whether NHS CHC should be provided. The assessment should also take into account your views and the views of any carers you have. You should be given a copy of the decision documents, along with clear reasons for the decision.

    You can download a blank copy of the NHS continuing healthcare decision support tool. If you’re eligible for NHS CHC, the next stage is to arrange a care and support package that meets your assessed needs.
  • Fast-track assessment for NHS CHC
    If your health is deteriorating quickly and you’re nearing the end of your life, you should be considered for the NHS CHC fast track pathway, so that an appropriate care and support package can be put in place as soon as possible – usually within 48 hours.

    An organisation called Beacon gives free independent advice on NHS CHC. Visit the Beacon website or call the free helpline on 0345 548 0300.