NHS Continuing Healthcare
CHC Checklist Advocacy and Attendance
Checklist screening support helps a family prepare for the NHS Continuing Healthcare Checklist, the screening stage that decides whether a full assessment goes ahead. A registered professional explains the process, prepares the evidence of need in the language the Checklist scores, can attend the screening meeting, and challenges the outcome where a Checklist is wrongly negative or has been refused altogether. The fee is £1,250 plus VAT, with travel charged separately.
A prospective Checklist, advocacy for the formal screening and attendance at the meeting, across England
At a glance
Role
A prospective Checklist, advocacy for the formal screening and attendance at the meeting
Framework
National Framework for NHS CHC and NHS-funded Nursing Care, 2022 revision
Format
Three steps: our own Checklist first, then advocacy to the ICB's partners, then attendance
Deliverable
A completed prospective Checklist, the advocacy letters, and a formal Checklist completed with us in the room
Coverage
England. Wales runs its own Continuing NHS Healthcare framework
£1,250
Fixed fee, plus VAT
One working day
Response to your enquiry
England
Cover throughout the country
Social work led
Registered professionals
Plain-English explanation
What Checklist advocacy and attendance is
A three-step service that gets the NHS Continuing Healthcare Checklist completed properly, by the right people, on the full evidence of need.
The Checklist is the screening tool that decides whether a full CHC assessment happens at all. It is scored A, B or C across eleven domains. Only a professional working with the Integrated Care Board can complete the formal one, and it is often done quickly, by someone who has met the person once.
We complete a prospective Checklist ourselves first. Where it is positive, we advocate to the care home, the social worker or the GP for the formal Checklist to be completed, and we attend that meeting so it is completed on the real picture of the person's needs.
A positive Checklist does not award funding
The Checklist is a screening tool. A positive result triggers the full assessment; it decides nothing about eligibility. Equally, a negative Checklist is a decision that can be challenged, and often should be.
Common situations
When you may need Checklist advocacy and attendance
The Checklist is the gateway to the whole CHC process. It is a screening tool completed by a health or social care professional working with the Integrated Care Board, and a positive result triggers the full Decision Support Tool assessment. Nellie Supports is not a partner of the ICB, so we cannot complete the formal Checklist ourselves. What we can do is complete a prospective one, and use it.
Anyone can ask for a Checklist to be completed, but requests are often deflected or delayed. A positive prospective Checklist from a registered professional changes that conversation: it gives the care home, the social worker or the GP a documented reason to complete the formal screening, and it gives us the evidence to present when we attend.
Nobody will arrange a Checklist
You have asked and been told there is no point, or the request has gone nowhere.
You are not sure the person would pass one
You want a registered professional to check, on evidence, before you push.
A Checklist has been arranged
You want someone who knows the tool in the room when it is completed.
A hospital discharge is being planned
Screening is being done at pace alongside discharge decisions.
The person presents well
Short conversations mask needs that only show over a day or a night.
A care home is completing it
You want the record to reflect what the notes actually show.
What is assessed
The eleven domains the Checklist screens
The Checklist records a level of A, B or C against eleven areas of need. It is a screening judgement, not a scoring exercise, and the threshold for triggering a full assessment is deliberately low. Getting the evidence right in each of these is what decides whether the person is assessed at all.
Breathing
Nutrition, food and drink
Continence
Skin integrity, including wounds, ulcers and tissue viability
Mobility
Communication
Psychological and emotional needs
Cognition
Behaviour
Drug therapies and medication, including symptom control
Altered states of consciousness
A Checklist is not the place to be modest
Families routinely describe a good day, and professionals routinely record what is currently provided rather than what is needed. Both understate the person. The Checklist should reflect a typical week, including the nights.
1
The threshold for a full assessment
NHS Continuing Healthcare in England is governed by the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, in its 2022 revision. The Checklist is the National Framework's screening tool, with a deliberately low threshold: its job is to decide who should receive a full assessment, not who is eligible.
Current needs recorded against the Checklist domains
Evidence supporting the selected levels of need
Whether the screening threshold for full assessment is met
The outcome, reasons and next steps explained to the person
2
How screening relates to eligibility
A positive Checklist leads to a full assessment; it does not establish CHC eligibility. Eligibility is considered through the full process against the primary health need test. Clear records of actual needs support both stages.
Framework: National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (2022 revision); the Checklist screening tool and its threshold; the primary health need test
For more, read our guide: The CHC Checklist explained
Offered Funded Nursing Care instead of a full assessment? Read: CHC versus Funded Nursing Care
The framework
The framework for CHC Checklist screening
Initial enquiry and triage
Contact us by phone, email or website form. We gather the key details and confirm whether Checklist advocacy and attendance is the right route within one working day.
Scope and fee
We confirm the scope, the fee plus VAT and any travel charge, in writing before you commit to anything.
Step one: the prospective Checklist
A registered social worker completes a prospective Checklist for the person, from the care records and a visit, using the same tool and thresholds the NHS applies. If it is negative we tell you plainly and explain the options.
Step two: advocacy for the formal Checklist
Where our Checklist is positive, we write to the care home, the social worker or the GP, enclosing it and setting out why the formal Checklist must now be completed. We follow that up until a date is set.
Step three: attendance at the Checklist meeting
The social worker attends the formal Checklist meeting and presents the evidence of need domain by domain, so it is completed appropriately. A positive result moves the case to the full Decision Support Tool assessment. A wrong negative is challenged in writing.
What happens next
How the three steps work
Evidence base
What we look at
Our prospective Checklist stands or falls on the record, so that is where we start.
The completed Checklist
Every domain level, and the reasoning recorded against it.
The care records
Daily notes and charts covering the period screened.
The care plan
What the person needs, against what the Checklist recorded.
Hospital and community correspondence
Discharge summaries, clinic letters and nursing entries.
Family and carer accounts
The night-time and fluctuating needs that rarely reach the notes.
The framework thresholds
What each domain level actually requires, applied properly.
Deliverable
What you receive
The work is practical and evidence led. You receive:
The Checklist process explained in plain English
A completed prospective Checklist, scored domain by domain by a registered social worker
Advocacy letters to the care home, the social worker or the GP, with follow-up until the formal Checklist is arranged
Attendance and representation at the screening meeting
Challenge of a wrongly negative or refused Checklist
A written summary of the outcome and the next steps
Who we work with
For solicitors, deputies, care providers and advisers
Instruction is straightforward and the evidential standard is consistent whichever stage we are brought in at:
Scope confirmed in writing
The stage, the fee and the timescale are confirmed in writing before instruction.
Evidence in the language of the framework
Needs are described against the care domains and the four key characteristics, not in general terms.
Peer review as standard
A second qualified professional reviews the work before it is submitted.
Honest merits advice
Where a case has no realistic prospect, we say so before you spend anything further on it.
Standard Checklist Support
£1,250 plus VAT
- A prospective Checklist completed by a registered social worker
- Advocacy to the care home, social worker or GP for the formal Checklist
- Attendance at the formal Checklist meeting
- A written challenge where the outcome does not match the evidence
- Peer review by a second qualified professional
For families who want the Checklist secured and completed properly. One fee, agreed in writing before any work starts, and never a percentage of what is recovered. Most CHC support is charged by the hour or as a share of the outcome, so the cost is unknown when you commit and grows the longer the case runs. Ours is stated up front, plus VAT and travel, and does not change if the case turns out to be harder than expected.
Enhanced Checklist Support
£2,350 plus VAT
- Everything in Standard
- An independent social care needs assessment and a written care plan (£1,100 plus VAT, charged once and never again)
- Required if you want us to attend and represent the person at the Decision Support Tool meeting
- See CHC Assessment (DST) Support
The needs assessment is the evidence base we draw upon at the Decision Support Tool stage, so it has to be in place before we can represent the person at the multidisciplinary team meeting. Choose Enhanced where there is a realistic prospect the Checklist will be positive and you want us alongside you at the full assessment.
Transparent pricing
Two levels of Checklist support
Standard covers the Checklist stage itself. Enhanced adds an independent social care needs assessment and a written care plan, which we need in place before we can attend and represent the person at the Decision Support Tool meeting. The assessment is charged once, at £1,100 plus VAT, and never again, whichever later stages you instruct us on.
For families
A clear fee, agreed in writing before we start, with no percentage of anything recovered. We explain what is happening in plain English and deal with the process so you do not have to.
For professionals
Scope, fee and timescale confirmed in writing before instruction. Evidence prepared against the care domains and the four key characteristics, peer reviewed by a second qualified professional.
Provider evidence
Why choose Nellie Supports for Checklist advocacy and attendance
The Checklist decides whether the person is assessed at all. Getting it right is the cheapest stage of the whole process.
Why families and professionals choose Nellie Supports
Social work led, not a claims company
Registered professionals prepare and present the evidence of need. We are not a call centre and not a no-win-no-fee operation.
Evidence in the language of the domains
Needs are described the way the screening scores them, so nothing important is lost in translation.
Published fees, plus VAT
The whole price is published and confirmed in writing before instruction. No percentages, no surprises.
A permanent employed team
A full-time, in-house multidisciplinary team, not an ad hoc panel of associates, with more than 11,000 assessments completed practice-wide.
Peer reviewed as standard
Everything we prepare is reviewed by a second qualified professional before it is used.
Honest about outcomes
The screening outcome is the assessors' decision and eligibility is the Integrated Care Board's. We never promise a result, and we say so plainly.
A daughter asked the hospital discharge team whether her father would be screened for NHS Continuing Healthcare before he moved to a nursing home. She was told, wrongly, that he would not qualify so there was no point. No Checklist was ever completed.
A registered social worker completed a prospective Checklist from the care records and a visit. It was positive in enough domains to require the formal screening. With that in hand, we wrote to the discharge team and the GP setting out the position: the Checklist threshold is deliberately low, our prospective Checklist showed it was met, and screening is how the question is answered, not a favour to be granted. The formal Checklist was arranged within a fortnight.
The social worker attended the meeting and presented her father's needs domain by domain from the care records, so the formal Checklist was completed on the full picture rather than on a short conversation with someone who had met him twice.
The Checklist came back positive, which meant a full Decision Support Tool assessment, not funding. But the screening had been done properly, on complete evidence, and the family walked into the full assessment already prepared.
This is an illustrative example. It does not describe any individual client.
How Checklist advocacy and attendance works in practice
Frequently asked questions
Frequently asked questions about Checklist advocacy and attendance
Does a positive Checklist mean funding is awarded?
No. The Checklist is a screening tool, not a decision. A positive Checklist triggers the full assessment, where a multidisciplinary team scores the person's needs across the twelve care domains using the Decision Support Tool. The Integrated Care Board then makes the eligibility decision based on whether the evidence shows a primary health need. The Checklist therefore opens the door to assessment; it does not itself award funding.
Why do you complete your own Checklist first?
Because it changes the conversation. Anyone can ask for a Checklist, but requests are often deflected or delayed. A prospective Checklist completed by a registered social worker, scored against the same thresholds the NHS uses, gives the care home, the social worker or the GP a documented reason to complete the formal one. We are not a partner of the ICB, so ours is not the formal Checklist, but it is the evidence that gets the formal one done.
What if the Checklist has already come back negative?
A negative Checklist can be challenged where it does not reflect the person's real needs, and screening can be repeated where needs change. We review the completed Checklist against the care records, set out where the scoring went wrong, and press for a re-screen or escalation where the evidence supports it.
What does the fee include?
The fee of £1,250 plus VAT covers the records review, the prospective Checklist, the advocacy letters and follow-up, attendance at the formal Checklist meeting and challenge of a wrong outcome, with peer review throughout. Travel for in-person attendance is the only possible addition and is confirmed in writing before booking.
Is this legal advice?
No. Nellie Supports provides independent social work assessment, evidence and advocacy support. We do not provide regulated legal advice, and where a legal remedy is needed we will say so and support your solicitor's work.
The CHC Checklist explained
What the screening tool is, what happens at the meeting and what a positive result actually means.
The NHS Continuing Healthcare process explained
A plain English guide to the Checklist, the Decision Support Tool, the MDT and the ICB decision.
CHC eligibility and primary health need
What a primary health need is and how the four key characteristics are judged.
Supporting guidance
Related NHS Continuing Healthcare guides
Independent Social Care Needs Assessment & Care Plan
Included in the new client price of every CHC service and charged once. Independent needs assessment and written care plan, also available on its own.
CHC Assessment Support: DST and MDT Meeting
Evidence prepared across the twelve care domains of the Decision Support Tool (DST) and representation at the multi-disciplinary team (MDT) meeting.
CHC Appeal Support: Local Resolution
Written submission and representation at local resolution with the Integrated Care Board, the first stage of a CHC appeal. The Independent Review Panel is a separate service.
CHC Review Support
Independent evidence for the 3 month and annual reviews of a care package, where a reassessment can reduce or withdraw funding.
Other CHC support stages
Discuss your case
Think a Checklist should be happening and it is not?
Contact Nellie Supports to discuss Checklist screening support. We will confirm the right starting point, the fee and the next steps in writing.
Written by Ben Slater, Founder and Managing Director, Nellie Supports. Read our editorial policy.