Author and Publication
Author: Ben Slater, Registered Social Worker, Founder and Managing Director of Nellie Supports
Reviewed by: Kerry Slater, Director of Operations
Last reviewed: 20 July 2026
Citation
1. Department of Health and Social Care (2022) National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Available at: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
2. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
3. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
4. Mental Capacity Act 2005, c. 9. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
This article is made available for general information, education and professional reference. It may be downloaded, printed and shared for non-commercial purposes, provided that it is reproduced in full, is not altered in any way, and is properly cited as the work of Nellie Supports Ltd. This material must not be edited, adapted, sold, republished, incorporated into commercial products, or used for commercial training, assessment, report-writing or advisory services without prior written permission from Nellie Supports Ltd.
This article does not constitute legal advice, clinical advice or a substitute for a decision-specific professional assessment. Where legislation, government guidance, court forms or external professional materials are referred to, those materials remain subject to their own copyright, licensing and re-use terms.
Abstract
This guide explains what happens after the Decision Support Tool has been completed in an NHS Continuing Healthcare assessment. It covers the multidisciplinary team recommendation, the Integrated Care Board decision stage, expected timescales, what should be provided in writing, what to check on the completed tool before the decision arrives, and what happens next in each outcome.
What happens after the Decision Support Tool is completed
The assessment ends and then, for many families, nothing happens for weeks. Understanding what is going on in that gap, and what you can usefully do during it, makes the wait considerably less difficult.
The recommendation is written up
After the meeting, the multidisciplinary team finalises the Decision Support Tool and writes its recommendation on whether the person has a primary health need. That recommendation should be reasoned, referring to the four key characteristics and explaining how the recorded needs support the conclusion, rather than simply stating an outcome.
It goes to the Integrated Care Board
The completed tool and recommendation go to the Board, which makes the eligibility decision. The Board is expected to accept a properly reasoned recommendation other than in exceptional circumstances. In some areas this is a panel process, in others a delegated decision, and the route varies considerably between Boards.
Timescales
The Framework expects the whole process from positive Checklist to decision to be completed within 28 days in most cases. The stage after the assessment is where delay most often accumulates. Ask for the expected decision date, and ask again in writing if it passes without contact.
Ask for the completed tool now
Do not wait for the decision. Request the completed Decision Support Tool as soon as it is finalised. Reading it before the decision arrives gives you time to identify errors and raise them while the matter is still open, which is considerably more useful than raising them afterwards.
What to check on it
Four things. Does each domain level match the narrative recorded beneath it? Does the narrative describe the need without the care in place, or only the managed presentation? Are any domains blank or thin? And is there actual reasoning on nature, intensity, complexity and unpredictability, rather than the four words appearing without analysis?
What you should receive
The written decision should include the outcome, the reasons, a copy of the completed Decision Support Tool, and information on how to seek a review. A decision communicated by telephone alone, or without the underlying paperwork, is difficult to test, so request the full documentation before deciding what to do.
Key takeaway
The team recommends, the Board decides, and the gap between them is where delay sits. Request the completed tool as soon as it is finalised rather than waiting, check it against the four points above, and raise anything you find in writing straight away.
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Frequently asked questions
How long should the decision take?
The Framework expects the whole process from positive Checklist to decision within 28 days in most cases. The stage after the assessment is where delay most often accumulates, so ask for an expected decision date.
Can I see the completed tool before the decision?
Ask for it. Practice varies but many teams will share it, and reading it before the decision arrives gives you time to raise errors while the matter is still open.
What should I look for on it?
Whether each level matches the narrative beneath it, whether needs are described without the care in place, whether any domain is blank or thin, and whether the four key characteristics have been reasoned rather than named.
Related NHS Continuing Healthcare pages
These links take you to the most relevant Nellie Supports service page and to the supporting guides that explain the surrounding process.
Speak to an independent CHC specialist
Nellie Supports prepares independent needs evidence for NHS Continuing Healthcare assessments, reviews and appeals across England and Wales. Our reports are written by registered social workers on a permanent employed team, with internal peer review before release. Call 0333 987 5118 or send an enquiry and we will talk through where you are in the process.