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.
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 the composition and role of the multidisciplinary team in an NHS Continuing Healthcare assessment. It sets out the minimum professional requirements, who else should contribute, the team's responsibility for completing the Decision Support Tool and making a recommendation, the role of the person and their family, and what to do where the team is not properly constituted.
Who sits on the CHC multidisciplinary team
The multidisciplinary team carries out the full NHS Continuing Healthcare assessment and makes the recommendation on eligibility. Who sits on it, and who contributes to it, has a direct effect on how accurately needs are recorded. This guide explains the composition and the responsibilities.
The minimum requirement
The Framework requires a multidisciplinary team of at least two professionals from different healthcare professions, or one healthcare professional and one social care professional. In practice a nurse assessor and a social worker is the most common pairing. The requirement is a minimum rather than a target, and where the person's needs span several areas, a team of two is often insufficient to describe them properly.
Who else should contribute
Contributions should be sought from professionals who know the person and their needs, which may include the GP, community nursing, specialist nurses such as tissue viability or epilepsy, occupational therapy, physiotherapy, speech and language therapy, dietetics, psychiatry, psychology and the care home or domiciliary provider. Contributions can be made in writing where attendance is not possible. A team that has heard from nobody who knows the person day to day is unlikely to record needs accurately.
What the team is responsible for
The team gathers and considers the evidence, completes the Decision Support Tool across the twelve care domains, analyses the needs through the four key characteristics of nature, intensity, complexity and unpredictability, and makes a reasoned recommendation on whether the person has a primary health need. The recommendation must be supported by the evidence recorded, and the reasoning should be written down rather than left implicit in the domain levels.
What the team does not do
It does not make the decision. The Integrated Care Board is the responsible commissioner and makes the eligibility decision, though it is expected to accept a properly reasoned recommendation other than in exceptional circumstances. The distinction matters, because a family told at the assessment that the team is recommending eligibility has not yet received a decision, and should not treat the outcome as settled until it arrives in writing.
The role of the person and their family
The person should be at the centre of the assessment and supported to participate. Family members and representatives can attend, provide evidence and comment on the completed tool. Where the person may lack capacity to be involved in the process, consideration should be given to whether an advocate is required. Contributions should be recorded even where the team disagrees with them, so that any later review can see where the disagreement lies.
Common problems with composition
The most frequent difficulties are a team of two who have never met the person, a social care representative attending without access to care records, no input from the provider actually delivering the care, and no specialist input in the area of greatest need. Any of these can be raised at the time, and raising it during the assessment is considerably more effective than raising it after the decision.
Preparing for the meeting
A short written summary is the most useful thing a family can bring. Set out the day to day picture, what happens overnight, how needs fluctuate, what interventions are in place and what happens when they lapse. Refer to dated records where possible. Ask for the summary to be attached to the Decision Support Tool, so it forms part of the evidence rather than a recollection of what was said.
If the team is not properly constituted
Where the minimum composition has not been met, or where nobody present knows the person, say so and ask for it to be recorded. If the assessment proceeds anyway, that record becomes a specific and identifiable point for any later review, which is far stronger than a general complaint that the assessment felt rushed or superficial.
Key takeaway
The multidisciplinary team needs at least two professionals from different disciplines, and should draw on everyone who knows the person's needs. It assesses and recommends, it does not decide. Contribute written evidence, ask for it to be attached, and record any concern about composition at the time.
Frequently asked questions
Can the team be just two people?
Yes, two is the minimum, though it is frequently insufficient where needs span several areas. Contributions from others who know the person can be provided in writing rather than in person, and should be sought.
Does a doctor have to attend?
No. The requirement is two professionals from different healthcare professions, or one healthcare and one social care professional. GP or specialist input is often provided in writing rather than by attendance.
Can family attend the assessment?
Yes. The person should be involved wherever possible and family or representatives can attend, provide evidence and comment on the completed tool. Ask for your contributions to be recorded even where the team takes a different view.
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.