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. R v North and East Devon Health Authority, ex parte Coughlan [2000] 2 WLR 622.
3. R (Grogan) v Bexley NHS Care Trust and others [2006] EWHC 44 (Admin).
4. NHS England. NHS Continuing Healthcare independent review process. Available at: https://www.england.nhs.uk/healthcare/
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 describes what happens at an NHS Continuing Healthcare Checklist meeting in England. It covers who completes the Checklist, how the eleven domains are scored using A, B and C levels, what threshold triggers a full assessment, how long the meeting usually takes, what families can contribute, and what the outcome does and does not decide.
What happens at a CHC Checklist meeting
The Checklist is the screening stage of NHS Continuing Healthcare. It is not the assessment itself and it does not decide whether funding is awarded. It decides only whether a full assessment should follow. Understanding what happens at the meeting, and what families can contribute to it, makes a meaningful difference to whether needs are recorded accurately at the outset.
What the Checklist is for
The Checklist is a screening tool with a deliberately low threshold. Its purpose is to identify people whose needs may indicate eligibility for NHS Continuing Healthcare so that they can proceed to a full assessment using the Decision Support Tool. Because it is a screening tool, it is designed to be over inclusive rather than precise. A positive Checklist is not a finding of eligibility, and a negative Checklist is not a finding that someone has no health needs. It is a gate, not a decision.
Who completes it and where it happens
A Checklist can be completed by a range of health and social care staff, including nurses, social workers, discharge coordinators and care home managers, provided they have been trained to use it. It can be completed in hospital, in a care home, in the person's own home or occasionally by telephone. It does not require a multidisciplinary team. In practice this means the person completing it may know the individual well or may have met them very recently, and that variation is worth being alert to.
Who can attend
The person being screened should be involved wherever possible, and family members, attorneys, deputies or other representatives can attend and contribute. Where the person may lack capacity to be involved in the process, consideration should be given to whether an advocate is needed. There is no requirement for a formal meeting with everyone present, but if you are told a Checklist is being completed you can ask to be part of it and to provide information before it is finalised.
How the Checklist is scored
The Checklist covers eleven care domains and each is scored A, B or C. A indicates a level of need that broadly corresponds to a high level in the Decision Support Tool, B a moderate level and C a low level or no need. The threshold for proceeding to a full assessment is met by two or more A scores, or five or more B scores, or one A score with four or more B scores. A single A score in certain domains can also trigger a full assessment where the need is of a particularly significant nature.
How long it takes
A Checklist is usually completed in well under an hour, and sometimes in twenty or thirty minutes. It is a short document and the guidance is explicit that detailed evidence is not required at this stage. That brevity is intentional, but it is also why Checklists are sometimes completed on limited information. If the person completing it has not seen the care records or spoken to the people who provide day to day care, the picture can be incomplete.
What families can usefully contribute
The most useful contribution is concrete, dated detail about what actually happens. Notes on night time care, falls, refusals of food or medication, episodes of distress, skin damage, infections and hospital attendances all help. Describing what would happen without the current care in place is particularly valuable, because needs that are well managed are frequently under recorded at the screening stage. Bringing a short written summary is more reliable than trying to recall detail during the meeting.
What the outcome means
If the threshold is met, the person should be referred for a full assessment using the Decision Support Tool, carried out by a multidisciplinary team. If the threshold is not met, the person is not referred forward at that point. A negative Checklist should be given to the person and their representative in writing, with reasons. It should also explain how to ask for the decision to be reconsidered, which is a right that is not always made clear at the time.
If you disagree with a negative Checklist
You can ask the Integrated Care Board to review a negative Checklist. The most effective challenges identify a specific domain where the recorded level does not match the evidence, and set out the evidence that supports a higher level. Because the threshold is low, correcting one or two domains is often enough to trigger a full assessment. You can also request that a new Checklist be completed if the person's condition has changed since the original screening.
Key takeaway
The Checklist is a short screening step with a low threshold, and it decides only whether a full assessment follows. Contributing accurate, dated evidence at this stage, and asking for written reasons for any negative outcome, gives you the best chance of the process moving forward on an accurate picture of need.
Frequently asked questions
Is consent needed for a Checklist?
Consent should be sought from the person for the process and for the sharing of information. Where the person may lack capacity to consent, a best interests decision should be made and recorded, and consideration given to whether an advocate is required. The process should not simply proceed without either consent or a recorded best interests decision.
Can a Checklist be skipped?
Yes, in two situations. A Checklist can be bypassed where it is already clear that a full assessment is needed, and it is not used at all on the Fast Track route, which has its own pathway tool. Otherwise the Checklist is the normal entry point to the process.
Should I receive a copy of the completed Checklist?
Yes. The completed Checklist and the outcome should be provided in writing to the person and, where appropriate, to their representative. If you have not received a copy, request it directly from the Integrated Care Board or the professional who completed it.
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.