CHC checklist, full assessment and the 12 care areas
In short
- The checklist is a quick check. Its bar is set low on purpose.
- The full assessment looks at 12 areas of need.
- Each area gets a level, from "no needs" to "priority".
- Ask to be there, and ask for copies of everything.
NHS Continuing Healthcare guide: Start here · Checklist, assessment and the 12 areas · Evidence and appeals · Should I pay a firm? · Free printable checklist
Step 1: The checklist
A nurse, doctor, other health worker or social worker fills in the CHC Checklist. You should be told it is happening. They must write down why they decided, sign it and date it. You should get a copy.
The checklist is meant to let anyone who might be eligible have a full assessment. A positive checklist does not mean you will get CHC.
Tip: ask for a checklist if you think you need one. You can ask the hospital ward, GP, district nurse, social worker or your local ICB.
Step 2: The full assessment
A team of at least 2 professionals from different health or care jobs (an "MDT") does the full assessment. They use the Decision Support Tool (DST). You and your family should be involved, and your views written down.
The 12 care areas, in plain words
- Breathing: for example, breathlessness, oxygen or suction.
- Nutrition: eating and drinking, choking risk, tube feeding.
- Continence: bladder and bowel care.
- Skin: wounds, ulcers and pressure sores.
- Mobility: moving, falls, being hoisted or turned.
- Communication: how you tell people what you need.
- Psychological and emotional needs: low mood, anxiety, distress.
- Cognition: memory, understanding and making choices.
- Behaviour: for example, behaviour that puts you or others at risk.
- Drug therapies and medicine: how complex your medicines are, and pain or symptom control.
- Altered states of consciousness: for example, fits or blackouts.
- Other significant care needs: anything else important not covered above.
The levels
Each area gets one level: no needs, low, moderate, high, severe or priority. Not every area has all levels.
The NHS says you can usually expect to be eligible if you have at least 1 priority need, or severe needs in at least 2 areas. You may also be eligible with 1 severe need plus other needs, or a number of high or moderate needs. It depends on how complex, intense or unpredictable your needs are. The team should look at the whole person, not just add up scores. See NHS: continuing healthcare.
Four key words
- Nature: what your needs are.
- Intensity: how much care, and how often.
- Complexity: how your needs mix and affect each other.
- Unpredictability: how hard it is to know when things will change, and the risk if care is late.
The fast track
If someone's health is getting worse quickly and they may be near the end of life, a clinician can use the Fast Track Pathway Tool. The NHS says care should usually be in place within 48 hours. No checklist or DST is needed first.
At the meeting
- Bring your diary and notes. Speak up if something is missed.
- Ask for each area to be talked through. Check the level and the reason.
- If you disagree, say so, and ask for it to be written down.
- Ask for a copy of the completed DST and the decision letter.
Information only. This page explains official guidance in plain English. It is not legal or medical advice. Rules can change. For advice about your own case, contact Citizens Advice or another free adviser.
Where this applies: England. Scotland, Wales and Northern Ireland have different rules.
Written by Social Care Made Easy. Last checked: 25 October 2026.