How to Apply for NHS CHC Funding: A Step-by-Step Guide

The CHC assessment is a two-stage process. Most families are surprised to learn how structured (and how challengeable) it is. Understanding the process is the first step to navigating it effectively.

Stage 1: The CHC Checklist (Tool 11)

The Checklist (formally known as Tool 11) is a screening tool. A healthcare or social care professional completes it, looking at 11 areas of need: breathing, nutrition, continence, skin, mobility, communication, behaviour, cognition, psychological and emotional needs, altered states of consciousness, and symptom control.

If the person scores above the threshold, they proceed to a full assessment. If not, CHC is declined at this stage (without any further assessment).

Many families are incorrectly screened out at the Checklist stage because domains are under-scored or needs are not fully described. An experienced nurse advocate attending this meeting can make a significant difference to the outcome.

Stage 2: The Decision Support Tool (DST)

If the person progresses past the Checklist, they move to a full multidisciplinary assessment using the Decision Support Tool (known as the DST). This is where eligibility is decided.

The DST is a 12-domain assessment framework, reviewed by a multidisciplinary team (MDT) that typically includes nurses, social workers, and other health professionals. The 12 domains are: behaviour, cognition, psychological and emotional needs, communication, mobility, nutrition, continence, skin, breathing, symptom control, medication, and altered states of consciousness.

Each domain is scored (None, Low, Moderate, High, or Severe) based on the person's needs. The overall picture determines whether a primary health need exists.

The Integrated Care Board (ICB) (the NHS body responsible for CHC in your area) then makes the final funding decision based on the DST outcome.