How to Prepare for an NHS Continuing Healthcare Assessment Visit

An NHS Continuing Healthcare assessment visit can feel overwhelming, particularly if a family is navigating it without any specialist guidance. The key is to understand what the assessors are looking for and to prepare accordingly.

What happens during the assessment visit?

The NHS Continuing Healthcare assessment is a structured clinical process using the Decision Support Tool (DST). Assessors (typically a nurse and a social worker representing the NHS and local authority respectively) will ask questions about the person's care needs across 12 domains: behaviour, cognition, psychological and emotional needs, communication, mobility, nutrition, continence, skin, breathing, symptom control, medication, and altered states of consciousness.

The meeting can take place in a care home, at the person's home, or in a hospital or community setting. The person being assessed may or may not be present, depending on their capacity.

Who can attend?

Family members and representatives have the right to attend the assessment meeting. This right is not always communicated by the ICB, but it exists. A nurse advocate can also attend, and in most cases, expert representation at this meeting makes a material difference to the outcome.

What to prepare in advance

• Gather all relevant documents before the visit. Do not rely on the assessors to have reviewed clinical records in detail.

• Prepare a brief written summary of the person's care needs, structured around the 12 DST domains. This gives the assessors a clear reference point and ensures nothing is missed.

• If the person's needs are variable or unpredictable, compile a log of typical difficult periods (incidents, escalations, emergency interventions) to demonstrate the pattern.

• Speak to care staff, district nurses, or the GP in advance. A brief note or letter from a clinician who knows the person well can support the assessment significantly.

What not to do during the assessment

Do not allow the assessment to focus only on a good day or a settled period. Assessors visit once, and the picture they observe on that day may not reflect the full reality of care needs. The responsibility falls on the family (or their representative) to describe the full picture, including the difficult times.

Do not minimise care needs out of politeness or habit. Families who have lived with a care situation for a long time sometimes understate how much care is actually being delivered. Be specific, be accurate, and be complete.

What happens after the assessment visit?

Following the DST assessment, the multidisciplinary team (MDT) meets to review the scores and make a recommendation. The Integrated Care Board (ICB) then makes the final funding decision. The family should be notified in writing. If the decision is a refusal, the reasons must be provided, and the decision can be challenged.