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The NHS Continuing Healthcare Checklist: what happens at the first screen?

The Checklist is not the final eligibility decision. It is a screening tool used to decide whether a person should move on to a full NHS Continuing Healthcare assessment.

The important point

The threshold is deliberately a screening threshold. A positive Checklist does not mean CHC will be awarded, but it should normally lead to a full assessment. A negative Checklist can be reconsidered if you disagree with it.

When should a Checklist be considered?

Where there may be a need for NHS Continuing Healthcare, the Checklist should normally be considered at the right time and place, when the person's ongoing needs are reasonably clear. It can be completed in a range of settings.

Who completes it?

A trained health or social care professional. NHS England's public explanation describes it as the usual first screening stage.

What does it look at?

It looks across the same broad areas of need that later feed into the full Decision Support Tool process.

What families should check

  • Were the needs described as they actually occur, including support needed to prevent incidents?
  • Were well-managed needs still recognised as needs rather than scored down simply because care is working?
  • Was the outcome explained and communicated clearly in writing?
  • If the result was negative, were reasons given for not proceeding to full assessment?
  • Has there been a material change in needs since an earlier assessment?

Well-managed needs still matter

National guidance says a need should not be marginalised merely because it is successfully managed. The correct question is what level of need exists and what care or intervention is required to manage it.

What happens after the Checklist?

01

Positive screen

The case should normally proceed to a full assessment, where a multidisciplinary team considers the evidence and completes the Decision Support Tool.

02

Negative screen

The person or representative can ask the Integrated Care Board to reconsider the decision if they disagree with it.

03

Fast Track may be different

Where someone has a rapidly deteriorating condition and may be entering a terminal phase, the Fast Track pathway may be appropriate instead of the usual Checklist route.

When a negative Checklist deserves scrutiny

A negative result is particularly worth reviewing where significant risks are being controlled by intensive care, several needs interact with each other, or the written reasons do not appear to match the care records. The issue is not to force a positive screen; it is to make sure the screen accurately captures the needs.

Primary sources: NHS England's 2025 Continuing Healthcare explainer and the GOV.UK NHS Continuing Healthcare Checklist guidance. NHS England explainer · Checklist guidance

Was the Checklist negative?

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