How will my eligibility for NHS continuing healthcare be assessed?

For most people, the first step is to have an assessment with a health or social care professional using a screening tool called the Checklist Tool. If this screening suggests that you may be eligible for NHS continuing healthcare, a full up-to-date assessment of your needs will be arranged, using a tool called the Decision Support Tool.

You should be fully involved in the assessment and decision-making process. Your views about your needs for care and support should be taken into account. If you feel that you need help to explain your views, you may want to ask a friend or relative for support.

Initial screening with the Checklist Tool

The Checklist Tool is used to decide whether you should be referred for a full assessment. It helps health and social care professionals to work out whether your care needs may be of a level or type that indicate you may be eligible for NHS continuing healthcare.

The Checklist Tool is usually completed when a nurse, doctor, other qualified healthcare professional or social worker is assessing or reviewing your health or social care needs. For example:

  • a nurse or doctor could carry out the initial screening before you leave hospital
  • a social worker could do the screening when carrying out a community care assessment

After the initial screening, your local clinical commissioning group (CCG) will write to you to confirm whether or not you will be referred for a full assessment for NHS continuing healthcare.

Full assessment with the Decision Support Tool

If the Checklist Tool shows that you may be eligible for NHS continuing healthcare, the person who completed it will contact your CCG to arrange a full up-to-date assessment of all your care needs.

The full assessment will be carried out by a multidisciplinary team made up of a minimum of two different health or care professionals who are already involved in your care, to build an overall picture of your needs. In some cases, more detailed specialist assessments may be required from these professionals.

The information from your assessment will be used to complete the Decision Support Tool. This tool is used to assess whether your main or primary care needs relate to your health, by looking at the following types of care need:

  • behaviour
  • cognition (understanding)
  • communication
  • psychological / emotional needs
  • mobility (ability to move around)
  • nutrition (food and drink)
  • continence
  • skin (including wounds and ulcers)
  • breathing
  • symptom control through drug therapies and medication
  • altered states of consciousness
  • other significant needs

For individuals who need an urgent package of care because their condition is deteriorating rapidly, the Fast Track Tool may be used instead. This enables the CCG to arrange for care to be provided as quickly as possible.

What happens after the assessment?

The multidisciplinary team will make a recommendation to the CCG about your eligibility for NHS continuing healthcare. For more information, see What happens after my assessment for NHS continuing healthcare?

Read the answers to more questions about caring, carers and long-term conditions.

Further information:

 

Coping with a long-term condition: the care plan

In this video, find out how a care plan helps patients take control of their condition by setting out goals that cater to their individual needs.

Media last reviewed: 27/04/2015

Next review due: 27/04/2017

Page last reviewed: 29/04/2015

Next review due: 28/04/2017