The CHC Checklist: asking, preparing and taking part

What the Checklist does

The NHS CHC Checklist is a national screening tool for adults in England. Its threshold is deliberately low so people who may qualify can have a full assessment. A trained health or social care practitioner, such as a nurse, doctor or social worker, can complete it. A positive result means referral for full assessment. It does not promise funding. You do not have to diagnose a primary health need or prepare a professional report before asking.

How to request screening

Contact your GP, community nurse, social worker or ICB CHC team. Explain your ongoing health and care needs and ask whether the Checklist should be completed. Keep the request date and contact details. Ask for the decision and reasons if screening is refused. Sometimes the ICB agrees to proceed directly to full assessment. Someone with a rapidly deteriorating condition who may be entering a terminal phase may need the fast-track pathway instead.

Choose the right time and setting

Screening should happen when ongoing needs can be understood. The full assessment normally takes place in the community, preferably at home. Temporary illness, rehabilitation and hospital discharge can affect timing; ask how ongoing needs will be distinguished from temporary needs. A Checklist is not always needed, including where section 117 aftercare already meets all assessed needs. Ask who will review needs if they change, rather than assuming an earlier decision lasts forever.

Plan how you will take part

You should have reasonable notice and an explanation of the process. Ask who will complete the Checklist and who you want present. Tell them how you communicate and what makes meetings accessible: pictures, your communication device, an interpreter, a familiar supporter, breaks or a quieter room. A supporter can contribute observations while keeping your own views distinct. Explain any need to arrange around fatigue, medication or care routines.

Consent and sharing information

You should be helped to understand and participate. Current guidance does not require consent simply to carry out the professional Checklist or share relevant information for direct care. Consent rules still apply to physical examinations and to sharing personal data with relatives, friends or representatives. Ask what will be shared and with whom. If there is a capacity concern, it must concern the particular decision and follow the Mental Capacity Act. Do not assume a person cannot decide because they have a learning disability or use few spoken words.

Understand the areas being considered

The Checklist covers breathing; food and drink; continence; skin; mobility; communication; psychological and emotional needs; cognition or understanding; behaviour; medication and treatment; and altered states of consciousness, such as some seizure-related needs. The practitioner matches the person’s needs to national descriptions marked A, B or C. These are screening descriptions, not a label of the person’s worth or a prediction of their future. Read the official form with support if helpful.

What makes a Checklist positive

A full assessment is normally triggered by at least two A ratings; five B ratings; one A and four B ratings; or one A in a domain marked with an asterisk. Exceptionally, a full assessment may be justified below those thresholds, with clear reasons. The scoring rules apply to screening, not a cash award. Do not transfer Checklist letters into the later Decision Support Tool: it uses different descriptions and a different decision process.

Prepare a short picture of daily support

Write what happens, what help is needed, who gives it, how often and for how long. Include night support, observation, prompting, skilled interventions and support that is needed but unavailable. Say whether an example is typical or unusual. Where needs fluctuate, show a representative period and explain better and worse days. Do not stop treatment, reduce support or create danger to prove a need. The optional worksheet is your preparation aid, not the official Checklist.

Gather relevant evidence without making a large bundle essential

Useful records may include current care plans, medication administration records, seizure records, bowel monitoring, swallowing plans, wound care information, incident records and recent specialist reports. Choose items that explain actual needs and responses. For example, a seizure record can show observations, rescue treatment and recovery support; a swallowing plan can explain positioning, assistance and monitoring. Only include what applies. The national Checklist is meant to be relatively quick and does not require a detailed evidence bundle. Missing a report should not automatically prevent screening.

Show the work behind successful support

A calm appointment or no recent incident may reflect careful support. Explain what people do to prevent distress, aspiration, seizures, skin damage or other problems. Record the skills and monitoring involved. Well-managed needs still count. This does not mean pretending medication or routine care is absent, or inventing harm that has not happened. Ask the practitioner to reflect the ongoing support in the appropriate domain and explain any difference of view.

Check the written outcome

Ask for the completed Checklist, reasons, date and who completed it. Check factual mistakes and whether your views and relevant needs were included. For a positive Checklist, ask when the ICB received the referral, who coordinates the full assessment and how you will be involved. The usual 28-calendar-day eligibility timescale runs from ICB receipt of the positive Checklist or other qualifying notification, with exceptions explained in the CHC guide. Appropriate support should continue while you wait.

If the Checklist is negative

You can ask the ICB to reconsider the result and provide missing or corrected information. The ICB must give the request proper consideration, but does not have to repeat the Checklist. Ask about the NHS complaints route if unresolved. NHS England’s independent eligibility review does not consider refusal of full assessment following a negative Checklist. If needs increase later, request fresh consideration. Where increase is expected within three months, ask whether a planned Checklist review has been recorded.

Getting ready for a CHC Checklist

Ask about the Checklist

Prepare for the meeting

Explain your care needs

Information and the decision

What you can do next

More useful links