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. R (Grogan) v Bexley NHS Care Trust and others [2006] EWHC 44 (Admin).
4. Social Work England. Professional standards. Available at: https://www.socialworkengland.org.uk
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 an independent needs assessment is in the context of NHS Continuing Healthcare. It covers who carries one out, how it differs from the Integrated Care Board's own assessment, what the assessment involves, how findings are structured against the twelve care domains, how the report is used at assessment and appeal, and what independence means in this context.
What an independent needs assessment is in CHC
An independent needs assessment is a separate professional assessment of what a person actually needs, carried out by someone with no interest in the funding outcome. It exists because the NHS assessment is carried out by the body that will pay if the answer is yes.
What it is
An assessment of a person's health and social care needs carried out by an independent registered professional, resulting in a written report. It describes what the person needs, how often, delivered by whom, with what skill, and what happens without it. It is not a second opinion on eligibility, since that decision belongs to the Integrated Care Board, but evidence the Board must consider.
Why independence matters
The Board assesses eligibility and also funds the care if the answer is positive. That is not an accusation of bad faith, but it is a structural position that anyone would recognise. An assessment carried out by someone with no financial interest in the outcome carries a different weight, particularly at Independent Review Panel where the panel is looking for material not generated by either side of the dispute.
What the assessment involves
Typically a visit to the person, observation of care being delivered, discussion with family and care staff, and a detailed review of care records, care plans, clinical correspondence and any previous assessment documentation. The records review is usually the part that produces the most, because it captures the pattern over time rather than a single visit.
How the findings are structured
A useful report organises findings against the twelve care domains, because that is the structure the decision will be made in. For each domain it should state the need, the intervention, its frequency and staffing, the skill required, and what would happen without it. It should then address nature, intensity, complexity and unpredictability separately.
How it is used
Before an assessment, it is submitted in advance and asked to be attached to the Decision Support Tool. At local resolution it forms the evidence base for the submission. At Independent Review Panel it is material the panel can weigh against the Board's own record. It can also inform a care plan where the issue is the adequacy of the package rather than eligibility.
What it does not do
It does not decide eligibility, it does not bind the Board, and it does not guarantee an outcome. What it does is put a professionally reasoned account of the person's needs in front of the decision maker, so that the decision is made on a complete picture rather than on a thin record compiled in a single meeting.
Key takeaway
An independent needs assessment is evidence, not a decision. Its value lies in being structured by domain, grounded in care records over time, reasoned against the four key characteristics, and produced by someone with no interest in the funding outcome.
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Frequently asked questions
Is this the same as the NHS assessment?
No. The NHS assessment is carried out by or for the Integrated Care Board and leads to the eligibility decision. An independent needs assessment is separate evidence about what the person needs, produced by someone with no interest in the outcome.
Does it decide whether we get funding?
No. Eligibility is decided by the Board. The assessment puts a professionally reasoned account of the person's needs before the decision maker so the decision is made on a complete picture.
When is the best time to get one?
Before the multidisciplinary assessment where possible, so it can be submitted in advance and attached to the Decision Support Tool. It is also used at local resolution and at Independent Review Panel.
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.