CHC, put simply.
The NHS Continuing Healthcare Assessment Process
A step-by-step guide to NHS Continuing Healthcare — from the initial Checklist to the final eligibility decision.
Checklist
The first screening stage.
The Checklist is the first stage of the CHC process. It is a screening tool used to decide whether a person should have a full NHS Continuing Healthcare assessment.
A positive Checklist means:
“More assessment is needed.” — not that someone is eligible for CHC.
Full Assessment
Gathering the full picture.
Information is gathered to build a complete picture of the person’s needs.
- Medical records
- Care plans
- Risk assessments
- Hospital records
- Family information
- Professional reports
Decision Support Tool
The structured DST meeting.
DST stands for Decision Support Tool. This is usually a meeting involving professionals and the individual or their family.
The purpose is to:
- Discuss needs
- Review evidence
- Consider risks
- Organise information
- Look at the whole picture
The DST is not a test. It is a framework to support decision making.
NICU Analysis
Nature, Intensity, Complexity, Unpredictability.
N
Nature
What are the needs?
I
Intensity
How much support is required?
C
Complexity
How do needs interact?
U
Unpredictability
How unpredictable are they?
This analysis sits at the heart of every CHC decision.
Primary Health Need
The central question.
The most important question in CHC:
Who is responsible for meeting these needs?
The NHS? Or another body?
If the person's main needs are health needs, they may have a Primary Health Need — the central concept in CHC eligibility.
The Decision
Eligible or not eligible.
✓ Eligible
The NHS becomes responsible for arranging and funding care.
Not Eligible
Other care pathways are considered depending on individual circumstances. If you disagree with the decision, there is a process for challenging it.
Important
There is no pass mark.
Many families are told:
“You need two Severe scores.”
“You need a Priority.”
This is not how CHC is intended to work.
The National Framework explains:
- Certain scores may indicate eligibility.
- But there is no automatic eligibility.
- Every decision must consider the totality of needs.
- Professional judgement applies.
- Whether the person has a Primary Health Need.
The CHC journey can feel complicated.
But at its heart, NHS Continuing Healthcare is trying to answer one simple question:
Who is responsible for meeting these needs?
Everything else in the process helps answer that question.
CHC Clarity · CHC, put simply.