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 Checklist.
3. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
4. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
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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 the outcome of an NHS Continuing Healthcare Checklist means. It covers the thresholds that trigger a full assessment, why a positive outcome is not a finding of eligibility, why a negative outcome is not a finding that the person has no health needs, what written information should follow, and the options available where the outcome appears wrong.
What a CHC Checklist outcome actually means
A Checklist outcome is frequently misread in both directions. Families are told they have been turned down when they have only been screened out, or told they have qualified when they have simply been referred forward. This guide explains what each outcome actually decides.
The two possible outcomes
A Checklist either meets the threshold to proceed to a full assessment or it does not. That is the whole of what it decides. It does not determine eligibility, it does not award or refuse funding, and it does not measure how ill someone is. It is a screening step whose only function is to sort people into those who need a full multidisciplinary assessment and those who, at this point, do not.
The threshold explained
The Checklist scores eleven domains at A, B or C. The threshold to proceed is met by two or more A scores, or five or more B scores, or one A with four or more B scores. A single A in certain domains may also trigger a full assessment where the need is of a particularly significant nature. The threshold is deliberately low, because the purpose is to avoid screening out people who might be eligible rather than to predict the final outcome.
What a positive outcome means
It means a full assessment should follow, carried out by a multidisciplinary team using the Decision Support Tool. It does not mean funding is likely. Many people who pass the Checklist are found not eligible at full assessment, and that is not a failure of the process, it is the process working as designed. Treating a positive Checklist as a promise of funding sets up a disappointment that was never warranted.
What a negative outcome means
It means the threshold was not met at this point. It does not mean the person has no health needs, that they will never be eligible, or that the question cannot be revisited. Needs change, and a Checklist reflects a moment. A negative outcome also does not prevent a fresh Checklist being requested where circumstances change, and it does not remove the right to ask the Integrated Care Board to review the outcome.
What you should receive in writing
The completed Checklist and the outcome should be given in writing to the person and, where appropriate, their representative. The written outcome should include the reasons and information about how to ask for the decision to be reconsidered. In practice this is frequently not provided, particularly where the Checklist was completed during a hospital discharge. If you have not received it, request it directly.
The most common misreading
The single most common error is treating a negative Checklist as a refusal of NHS Continuing Healthcare. It is not, and describing it that way in later correspondence can weaken your position. The accurate description is that the person was not referred forward for a full assessment. That framing matters, because the remedy is different: you are asking for the screening to be revisited, not appealing an eligibility decision.
If the outcome looks wrong
Ask for a copy and read each domain against the descriptors. Identify any domain where the recorded level does not match the evidence, and set out the dated evidence supporting a higher level. Because the threshold is low, correcting one or two domains is often enough. Where the person's condition has changed since, ask for a new Checklist instead, which is usually quicker than disputing the old one.
Timing and what follows
Where the threshold is met, the Framework expects the process from Checklist to eligibility decision to be completed within 28 days in most cases. Ask the Integrated Care Board to confirm the date it holds as the start point, since that date matters if the process runs slowly and if funding later needs to be backdated.
Key takeaway
A Checklist decides one thing only: whether a full assessment follows. Positive does not mean eligible and negative does not mean refused. Get the outcome in writing, read it against the descriptors, and either ask for a review or request a fresh Checklist if circumstances have changed.
Frequently asked questions
Is a negative Checklist a refusal of CHC funding?
No. It means the screening threshold was not met at that point, so no full assessment follows. It is not an eligibility decision, and describing it as a refusal in later correspondence can confuse the position you are actually challenging.
Does a positive Checklist mean I will get funding?
No. The threshold is deliberately low so people are not screened out too early. Many who pass the Checklist are found not eligible at full assessment. It confirms only that a fuller look at the needs is warranted.
How soon can a new Checklist be requested?
There is no fixed limit. A new Checklist can be requested whenever there has been a relevant change in condition or circumstances. Identify what has altered since the last one, since a repeat request without any change is less likely to succeed.
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.