Free NHS CHC Evidence Checklist

About this checklist

This NHS CHC evidence checklist is an organisational aid. It lists document categories that families, representatives and advocates commonly gather when preparing for an NHS Continuing Healthcare Checklist, a full Decision Support Tool assessment, or a review of a decision that has already been made.

Which documents matter depends entirely on the person’s circumstances and on the needs being considered. Some categories on this list will not exist for the person concerned, and some will not be relevant. A longer list of documents does not mean a stronger case, and this tool deliberately produces no score, percentage or readiness rating.

CHC Guard is independent software. It is not affiliated with, endorsed by or operated on behalf of the NHS, NHS England, any Integrated Care Board or the UK Government. It does not determine or predict eligibility for NHS Continuing Healthcare, does not recommend Decision Support Tool domain levels, and does not provide legal or medical advice. For advice about an individual case, speak to the relevant Integrated Care Board or an appropriately qualified adviser.

What is an NHS CHC evidence checklist for?

NHS Continuing Healthcare is a package of care arranged and funded solely by the NHS for adults in England who have been assessed as having a primary health need. The National Framework for NHS Continuing Healthcare sets out how that assessment is carried out, and it is an evidence-based process: the multidisciplinary team works from what the records show about the person’s day-to-day needs.

That is why gathering documents matters. The specific, dated detail — how often a fall happened, how many staff were needed at each transfer, how a night of distress was managed — usually sits in the care records rather than in anyone’s recollection. A checklist helps make sure a category of records is not simply forgotten.

• Before a Checklist — the screening stage decides whether a full assessment should follow, so it helps to know what records exist
• Before a DST assessment — the multidisciplinary team considers evidence across the recognised care domains
• After a decision — the decision letter and the assessment documents are the starting point for understanding how the conclusion was reached
• Before a review or challenge — records covering the relevant period, and records showing how needs changed, are often the most useful

Which documents for a CHC assessment are usually most useful?

No document is mandatory and no list can be complete, but a few categories come up again and again because of the level of dated detail they contain.

• Daily care notes — shift-by-shift entries describing what actually happened, often the richest source of dated detail
• Incident and falls records — individual events, what was found, who responded and what followed
• The current care plan — how care is intended to be delivered, including planned staffing for each area of need
• MAR charts — administered and as-required medication, refusals and any patterns over time
• Repositioning, nutrition and continence charts — routine monitoring records, where these are kept
• Clinical letters and discharge summaries — professional descriptions of conditions, interventions and changes

How DST evidence is organised across the care domains

The Decision Support Tool organises needs into twelve care domains, such as mobility, cognition, behaviour, nutrition, continence, skin integrity, breathing, communication, psychological and emotional needs, drug therapies and medication, altered states of consciousness, and other significant care needs.

When gathering NHS Continuing Healthcare documents it can help to think domain by domain: for mobility, the falls and moving-and-handling records; for nutrition, the food and fluid charts and any SALT input; for skin, wound care and repositioning records. This is a way of organising your gathering, not a way of scoring anything. Only the multidisciplinary team records domain levels, and CHC Guard never suggests them.

How to request records you do not hold

Care homes and care providers usually hold the day-to-day records and can normally provide copies on request. GP practices and NHS trusts hold clinical records. Where you are acting for someone else, you may need to show your authority to act, such as a lasting power of attorney, or the person’s consent.

Under UK data protection law an individual can request a copy of their own personal data, and someone with appropriate authority can request it on their behalf. Requests are normally answered within one month. Asking for a specific date range and specific record types tends to produce a faster, more usable response than asking for everything.

What this checklist deliberately does not do

• It does not determine or predict eligibility for NHS Continuing Healthcare
• It does not calculate a likelihood, score, percentage or readiness rating
• It does not imply that having more documents improves anyone’s chances
• It does not recommend or suggest Decision Support Tool domain levels
• It does not provide legal advice or medical advice
• It does not send your ticks, notes or any health-related information anywhere