Continuing healthcare checklist: what UK healthcare providers need

This guide explains the key information that health and social care workers need to provide when completing an NHS Continuing Healthcare (CNC) checklist. A continuing healthcare check involves screening patients to confirm whether they’re eligible for an NHS continuing healthcare full assessment. Continuing care provides fully-funded treatment outside a hospital setting on an ongoing basis. The full assessment process is overseen by the NHS Integrated Care Boards (ICB), which make a final decision on whether a patient is eligible for continuing care, what kind of care should be provided and the funding that needs to be allocated for the patient.

Completing the continuing healthcare checklist is usually the first step for healthcare and social care workers when screening patients to determine their eligibility for a full assessment under the NHS’s continuing healthcare service. 

According to the NHS website, continuing healthcare provides fully-funded healthcare for complex health or social care needs. Patients are typically informed of the process and what it entails before any screening or assessments begin.

Healthcare and social workers trained to complete the checklist include (but are not limited to):

The checklist works as a rudimentary screening to determine whether a patient is eligible for a full assessment. The full assessment then confirms whether a patient qualifies for continuing healthcare. 

To successfully apply for continuing healthcare, healthcare practitioners usually have to demonstrate that a patient has significant needs across what are known as ‘care domains’. In this next section, we will outline the 12 care domains. 

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The continuing healthcare checklist covers 12 care domains. These are:

Each care domain is evaluated based on three different levels of need severity, which are detailed below. By demonstrating the severity of a patient’s needs according to each care domain, healthcare providers can confirm whether they are eligible for continuing healthcare. 

During the completion of the CHC checklist, healthcare professionals assign a level of need – A, B, or C. These levels reflect the intensity of a patient’s needs and are ascribed to each care domain. Healthcare practitioners can therefore use these levels to describe the severity of their patient’s need for each domain. Each letter corresponds to an increase in intensity:

The NHS’s continuing healthcare checklist guidance explains that if a patient meets any of the following criteria, then they are likely eligible for a full assessment:

Here are a few examples: If a patient demonstrates a high level or ‘A’ need for both mobility and skin and tissue care domains, they are probably eligible for a full continuing healthcare assessment. 

If a patient demonstrates a high level or ‘A’ need for behaviour but does not have any other care domain needs, they can also undergo a full assessment.

Patient need levels can fluctuate over time. What may initially be a moderate need for a patient could escalate into a priority need, for example. Therefore, care providers can use this opportunity to make a note of whether a patient’s needs are unpredictable as well as possible outcomes if their needs are not met in time. 

To complete the continuing healthcare checklist for a patient, it is important to prepare the required information in advance. This is because the following information needs to be provided when filling out the checklist form:

Once these sections have been completed, you must then highlight the outcome based on patient needs and the evidence provided. There are two possible outcomes on the checklist:

Then, the healthcare provider or patient representative needs to provide a justification for this conclusion in the box below. Following this, they must provide:

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In some cases, it might be appropriate to fast-track a patient’s application using the NHS’s continuing healthcare fast-track pathway tool. Here are some common reasons for fast-tracking:

It may also be possible to skip completing a CHC checklist if it is clear that a patient does not have any needs. If a patient is receiving care under Section 117 of the Mental Health Act, they may not require additional continuing healthcare on top of this. According to the NHS, Section 117 states that a patient can receive free support and care following their leave from hospital. 

A CHC checklist only provides an initial assessment of whether a patient is eligible for continuing healthcare. Once a healthcare provider confirms that a patient is eligible for a full continuing healthcare assessment, this information is sent to the NHS’s integrated care boards (NHS organisations commissioning local health services). 

Integrated care boards then conduct a full assessment to confirm whether a patient can expect to receive continuing healthcare. This means that while a patient may be eligible for a referral for a full assessment, it does not automatically mean that they will receive continuing healthcare. This next step confirms this.

Once the local Integrated Care Board has made a decision, they will then provide patients with confirmation regarding whether their full assessment has been successful or not. Usually, these results are received within 28 days, according to the NHS.

Collecting the right information for a continuing healthcare checklist helps make the application process smoother for healthcare workers and their patients. By supplying the right information, you have a better chance of ensuring that patients are eligible for the additional support they need.