What the Checklist is
The Checklist is the screening stage of the NHS Continuing Healthcare process. Its purpose is to identify people who may need a full assessment of eligibility, and the guidance is explicit that it is designed to be used by a wide range of practitioners and that it does not itself determine eligibility. Source: Department of Health and Social Care, NHS continuing healthcare checklist guidance, last updated 27 October 2022.
It follows the same subject areas as the full assessment, in less detail. If you want to know what those subjects are, they are set out on our 12 care domains page.
Who completes it
A health or social care practitioner completes it, and the guidance expects practitioners using it to have received appropriate training. It can happen on a hospital ward before discharge, in a care home, or in the community. Source: Department of Health and Social Care, NHS continuing healthcare checklist guidance, last updated 27 October 2022.
The framework also expects the individual or their representative to be informed that a Checklist is being completed, and to be given a copy of the outcome with the reasons for it. Source: Department of Health and Social Care, National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, last updated 27 October 2022.
What happens after
- It goes forward. The Checklist is referred to the integrated care board and a full assessment using the Decision Support Tool is arranged with a multidisciplinary team.
- It does not go forward. No full assessment is arranged at this point. The outcome and reasons should be recorded and shared with you, and you can ask the board to reconsider.
Either way, the eligibility decision itself always sits with the board after a full assessment. Source: The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012, Part 6.
What a family or representative may contribute
The decision support tool guidance says practitioners should make all reasonable efforts to seek the participation of the individual or their representative at each stage, that their view should be considered, and that where consent to share information has been given, the views and knowledge of family members, friends, advocates and representatives should be taken into account. Source: Department of Health and Social Care, NHS continuing healthcare decision support tool guidance, last updated 27 October 2022.
The information most often missing at this stage is the ordinary detail:
- How many times something happens in a night, on a normal night.
- How long a task takes, and whether it takes one person or two.
- What has already happened when help was late, missed or unavailable.
- How much the week varies, and what triggers the bad days.
- Which pieces of equipment are in use, and who maintains and checks them.
None of that is a claim about eligibility. It is a description of care, and it is the part only you can supply. The free typical day record sheet walks you through recording it.
If the Checklist did not go forward
You can ask the integrated care board to reconsider the screening outcome, and the useful version of that request is one that puts specific, dated care information on the record rather than restating a disagreement.
The CHC Family Evidence Pack builds exactly that for this stage: your account written up across the 12 domains, plus a Checklist reconsideration letter. If a full assessment has already happened instead, it builds a review request letter rather than a reconsideration letter. Nobody receives both, because the two stages are different requests.
Questions families ask
Is the Checklist the assessment?
No. The Checklist is a screening tool used to decide whether a full assessment of eligibility should take place. It does not decide eligibility. Source: Department of Health and Social Care, NHS continuing healthcare checklist guidance, last updated 27 October 2022.
Who can complete a Checklist?
A range of health and social care practitioners can complete it, and the guidance expects them to have been trained in its use. A family member cannot complete it themselves, but can ask for one to be considered. Source: checklist guidance, last updated 27 October 2022.
Can I ask for a Checklist to be done?
You can raise it with the person's GP, ward discharge team, community nurse or social worker and ask for a Checklist to be considered. The framework expects the individual or their representative to be informed and involved. Source: National Framework and checklist guidance.
What if the Checklist does not go forward to a full assessment?
The outcome should be recorded and communicated with reasons, and you can ask the integrated care board to reconsider it. That is one of the two situations our pack is built for, the other being after a full assessment. Source: National Framework, last updated 27 October 2022.
Sources
- Department of Health and Social Care, NHS continuing healthcare checklist guidance, last updated 27 October 2022.
- Department of Health and Social Care, National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, last updated 27 October 2022.
- Department of Health and Social Care, NHS continuing healthcare decision support tool guidance, last updated 27 October 2022.
- The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012, Part 6.