Every week, thousands of families attend NHS Continuing Healthcare (CHC) assessments believing that if their relative is “clearly poorly enough,” funding will naturally follow.
Unfortunately, that’s rarely how the system works.
I’ve seen families lose funding not because they weren’t eligible, but because they didn’t understand how the assessment process actually operates.
The NHS isn’t assessing how deserving someone is. It’s assessing whether they have a Primary Health Need using a very specific legal framework.
Here are the 20 most common mistakes that can reduce the chances of a successful outcome.
1. Waiting Until Money Runs Out
Many families only explore CHC after paying care home fees for months or years.
If someone may be eligible, an assessment should be requested as soon as possible.
Delaying can cost tens of thousands of pounds.
2. Assuming a Care Home Will Arrange Everything
Some care homes are excellent at identifying potential eligibility.
Others have limited experience with CHC.
Ultimately, the responsibility for requesting an assessment rests with the individual or their representative.
3. Thinking a Diagnosis Qualifies Someone
Alzheimer’s disease.
Parkinson’s disease.
Stroke.
Cancer.
None of these diagnoses automatically qualify someone for CHC.
Eligibility depends on the nature, intensity, complexity and unpredictability of care needs—not the diagnosis itself.
4. Underplaying Needs
Families often say things like:
“She’s having a good day today.”
Or:
“He can usually manage.”
Wanting to present a loved one positively is completely understandable.
Unfortunately, assessments should reflect the person’s needs on their worst typical days, not their very best.
5. Forgetting Night-Time Needs
Many assessments focus heavily on daytime care.
But frequent repositioning, incontinence care, distress, wandering, medication or behavioural support overnight can significantly affect eligibility.
6. Believing Mobility Means Independence
Someone may be able to walk.
That doesn’t necessarily mean they are safe.
Supervision to prevent falls, constant prompting, physical assistance or unpredictable behaviour all matter.
7. Not Challenging Inaccurate Records
Care records aren’t always correct.
Missing incidents.
Incorrect risk assessments.
Outdated care plans.
Errors happen.
If something is inaccurate, raise it before the assessment wherever possible.
8. Not Keeping Evidence
Families often rely on memory.
Instead, keep records of:
- Falls
- Hospital admissions
- GP visits
- Behaviour incidents
- Weight loss
- Pressure damage
- Medication changes
- Emergency call-outs
Evidence always carries more weight than recollection.
9. Confusing Social Care With Healthcare
Needing help washing or dressing alone doesn’t usually qualify someone.
However, if those needs arise because of complex health issues, risks or skilled interventions, they may contribute towards eligibility.
Understanding the distinction is critical.
10. Thinking Dementia Automatically Qualifies
One of the biggest myths.
Many people with dementia are not eligible.
Many people without dementia are.
It’s always about assessed healthcare needs—not diagnosis.
11. Accepting the Checklist Outcome Without Question
The Checklist is only a screening tool.
If it isn’t completed correctly, someone may never receive a full assessment.
Families can ask questions, request clarification and challenge poor decisions.
12. Arriving Unprepared
Walking into a Decision Support Tool (DST) meeting without understanding:
- The care domains
- Levels of need
- Primary Health Need
- The National Framework
places families at an immediate disadvantage.
Preparation changes everything.
13. Assuming Professionals Always Agree
Different professionals frequently disagree during assessments.
Nurses.
Social workers.
Care home staff.
GPs.
Families should feel confident contributing their own evidence and observations.
14. Focusing Only on Medical Conditions
The assessment isn’t about illnesses.
It’s about the care required because of those illnesses.
Always describe what happens.
How often.
What support is needed.
What happens if support isn’t provided.
15. Forgetting Historical Patterns
Assessments look at current needs, but history matters.
Repeated infections.
Recurring falls.
Episodes of challenging behaviour.
Repeated hospital admissions.
Patterns help demonstrate unpredictability.
16. Believing the Highest Scores Guarantee Funding
Receiving a Severe or Priority level in one domain doesn’t automatically determine eligibility.
Equally, people without any Severe scores may still qualify.
The whole picture matters.
17. Not Reading the DST Before the Meeting
Ask for a copy.
Read every domain carefully.
Highlight inaccuracies.
Prepare examples.
Never attend blind.
18. Being Intimidated by the Process
Assessments can feel overwhelming.
Remember:
You are the expert in your loved one’s daily life.
Your evidence is valuable.
Your voice matters.
19. Missing the Appeal Deadline
If funding is refused, don’t assume that’s the end.
Many decisions are overturned.
But appeals usually have time limits.
Act promptly.
20. Trying to Learn Everything During the Assessment
Perhaps the biggest mistake of all.
The CHC process has:
- Legal tests
- National guidance
- Clinical terminology
- Scoring systems
- Assessment domains
- Appeals procedures
Trying to understand it while sitting in the meeting is like revising for an exam after it’s started.
Preparation is everything.
Don’t Walk Into an Assessment Unprepared
The NHS Continuing Healthcare process is complex—but it doesn’t have to be confusing.
That’s exactly why we created our comprehensive guide.
Inside you’ll discover:
✅ How the Checklist really works
✅ Every Decision Support Tool (DST) domain explained in plain English
✅ What assessors are actually looking for
✅ The legal test for a Primary Health Need
✅ How to gather evidence that carries weight
✅ Common assessor mistakes
✅ What to do if funding is refused
✅ Practical examples throughout
Whether you’re preparing for your first assessment or appealing a decision, this guide is designed to help you approach the process with confidence.
Get the Guide Today
Every year, families spend thousands of pounds unnecessarily because they don’t fully understand the CHC process.
A few hours of preparation could make an enormous difference.
Download the Carentis NHS Continuing Healthcare Assessment Guide today and go into your assessment informed, confident and prepared.
Frequently Asked Questions
Can I ask for a CHC assessment myself?
Yes. Anyone can request an NHS Continuing Healthcare Checklist if they believe they or their relative may have eligible healthcare needs.
Does having dementia mean someone qualifies?
No. Dementia alone does not determine eligibility. The assessment considers the person’s healthcare needs rather than their diagnosis.
Can I appeal if CHC funding is refused?
Yes. There is a structured appeals process, and many decisions are successfully challenged when the evidence supports eligibility.
Is the Decision Support Tool the final decision?
No. The DST is a recommendation tool used by the multidisciplinary team. The Integrated Care Board (ICB) makes the final eligibility decision, although it will usually follow the MDT’s recommendation.
Final Thought
The greatest advantage in a Continuing Healthcare assessment isn’t having the most serious diagnosis—it’s understanding how the system works.
The more prepared you are, the better equipped you’ll be to ensure your loved one’s needs are accurately represented.
Knowledge doesn’t guarantee funding. But a lack of knowledge can cost families thousands of pounds.