What Documents Do You Need for an NHS Continuing Healthcare Application?

Preparation is one of the most powerful things a family can do before an NHS Continuing Healthcare assessment. Having the right documents and evidence ready, and knowing how to present them within the assessment framework, can significantly improve the outcome.

Why does documentation matter?

The NHS Continuing Healthcare assessment is based on a structured clinical framework. The assessors score the person's needs across 12 domains using the Decision Support Tool (DST). Each score must be justified by evidence. If the evidence supporting a higher score is not presented at the assessment, that domain is likely to be scored lower than it should be.

The NHS assessors rely on clinical records. But clinical records do not always capture the full picture, particularly the day-to-day reality of care needs at home, the frequency of incidents, or the unpredictability of the person's condition.

Key documents to gather before the assessment

• GP records and letters: Evidence of diagnosis, medication, and clinical input. A letter from the GP specifically addressing care needs and complexity is particularly useful.

• Hospital discharge summaries: These set out the person's condition and care requirements at the point of leaving hospital.

• Community nursing or district nurse records: Log of clinical visits, wound care, catheter management, medication administration, or other nursing interventions.

• Care home records (if applicable): Daily care logs, incident reports, and care plan documents.

• Carer logs or diary: If the person is cared for at home, a written record of care interventions across a typical 24-hour period is extremely valuable. This should capture frequency, complexity, and any episodes of distress or unpredictability.

• Specialist assessments: Reports from physiotherapists, occupational therapists, speech and language therapists, or specialist nurses.

• Medication records: Particularly important where the medication regime is complex, requires skilled administration, or involves significant clinical oversight.

What about evidence of unpredictability?

Unpredictability is one of the four criteria used to determine a primary health need, and one of the most commonly underscored. Evidence of unpredictability includes incident logs (falls, episodes of severe agitation, sudden deterioration), records of emergency GP or hospital callouts, notes from carers about difficult or unpredictable periods, and any clinical correspondence that refers to instability in the person's condition.

Can a family member present evidence at the assessment?

Yes. Family members have the right to attend both the NHS Continuing Healthcare Checklist and DST assessment meetings, and to contribute information about the person's care needs. A nurse advocate can attend alongside the family, or in their place, to ensure the evidence is presented effectively within the clinical framework that assessors use.