If you’ve been told that your loved one “needs a CHC Checklist,” one of the first questions you’ll probably ask is:
Who actually completes it?
The answer is often less straightforward than it should be. Many families are incorrectly told that only a social worker can complete the Checklist, that someone must already be in a care home, or that a GP needs to do it.
None of those statements are true.
Understanding who can complete the NHS Continuing Healthcare (CHC) Checklist is important because delays at this stage can postpone access to a full assessment and, ultimately, NHS-funded care.
What is the CHC Checklist?
The NHS Continuing Healthcare Checklist is a screening tool, not the assessment itself.
Its purpose is simply to identify whether someone may have a primary health need and therefore requires a full NHS Continuing Healthcare assessment using the Decision Support Tool (DST).
It does not decide whether someone qualifies for NHS Continuing Healthcare.
The threshold is deliberately set relatively low to ensure people who may be eligible are not missed.
Who can complete the Checklist?
According to the National Framework for NHS Continuing Healthcare, the Checklist should be completed by a health or social care professional who has been appropriately trained in its use.
This could include:
- NHS nurses
- Community nurses
- District nurses
- Hospital discharge nurses
- Social workers
- Occupational therapists
- Physiotherapists
- Care coordinators
- Other healthcare professionals involved in the person’s care
The key requirement is not their job title but that they:
- understand the National Framework;
- have appropriate knowledge of the individual’s needs; and
- have been trained to complete the Checklist correctly.
Can a GP complete it?
Yes.
A GP can complete a Checklist if they have sufficient knowledge of the person’s needs and are appropriately trained.
However, many GP practices choose not to carry out CHC Checklists because of workload or local arrangements.
If your GP declines, this does not prevent a Checklist from being completed by another suitable professional.
Can a care home complete the Checklist?
This is where confusion often arises.
Many care homes have experienced registered nurses or managers who understand Continuing Healthcare extremely well.
However, the Checklist should only be completed by someone who has been trained and is recognised locally to undertake CHC screening.
In many areas, the Integrated Care Board (ICB) asks community nurses or CHC nurses to complete the Checklist rather than care home staff.
That does not mean the care home cannot request one.
In fact, care home staff often provide much of the evidence that supports the Checklist because they know the resident’s day-to-day needs better than anyone.
What if the person lives at home?
People often assume NHS Continuing Healthcare only applies to people living in nursing homes.
It doesn’t.
Someone can be assessed while living:
- in their own home;
- with family;
- in supported living;
- in residential care;
- in a nursing home; or
- in hospital.
If someone lives at home, the Checklist is usually completed by a healthcare professional already involved in their care, such as a community nurse, district nurse or another clinician who understands their needs.
The location does not affect whether someone can be considered for NHS Continuing Healthcare.
Can families complete the Checklist?
Families cannot complete an official NHS Checklist themselves.
However, they should always be involved in the process.
Relatives often have valuable information about:
- behaviour that professionals rarely witness;
- the level of supervision required;
- overnight care;
- risks and incidents;
- fluctuating needs; and
- the impact of medical conditions on daily life.
This information should be considered when the professional completes the Checklist.
What happens after the Checklist?
If the Checklist reaches the required threshold, the NHS should arrange a full Continuing Healthcare assessment.
This usually involves:
- gathering evidence from health and social care professionals;
- completion of the Decision Support Tool (DST);
- a multidisciplinary team (MDT) assessment; and
- a recommendation to the Integrated Care Board on eligibility.
Importantly, a positive Checklist does not guarantee funding, but it does mean there is enough evidence to justify a full assessment.
Can the NHS refuse to complete a Checklist?
Sometimes families are told:
- “They’re not poorly enough.”
- “They’re only in residential care.”
- “They have dementia, so they won’t qualify.”
- “We only assess people in nursing homes.”
These are not valid reasons to refuse a Checklist.
If there is evidence that someone may have a primary health need, they should normally be offered a Checklist unless they are already clearly eligible or clearly not eligible under the National Framework.
What if nobody will complete one?
If professionals refuse to undertake a Checklist, ask them:
- Why they believe the National Framework does not apply.
- Who is responsible locally for CHC screening.
- To provide the decision in writing.
You can also contact your local NHS Continuing Healthcare team within the Integrated Care Board and request that a Checklist is arranged.
Keeping a written record of requests and responses can be extremely helpful if there are later delays or disputes.
Common myths
“You have to be in a nursing home.”
False. People can qualify while living in their own home, residential care, supported living or hospital.
“Only a social worker can complete it.”
False. Any appropriately trained health or social care professional may complete the Checklist.
“The GP has to do it.”
False. A GP can complete it, but they are not the only professional who can.
“The care home decides whether someone gets CHC.”
False. Care homes can identify concerns and provide evidence, but eligibility decisions are made through the NHS Continuing Healthcare assessment process.
The Bottom Line
The NHS Continuing Healthcare Checklist is designed to ensure that people who may have a primary health need are identified for a full assessment.
Whether someone lives at home or in a care home makes no difference to their right to be considered.
The Checklist should be completed by an appropriately trained health or social care professional who understands the individual’s needs. Families cannot complete it themselves, but their knowledge and evidence should play an important role in ensuring the Checklist accurately reflects the person’s day-to-day care needs.
If you’re told a Checklist cannot be completed because of where someone lives or because “we don’t do that here,” it’s worth asking for the reason in writing. The National Framework is clear that access to NHS Continuing Healthcare should be based on a person’s needs—not their address or the organisation providing their care.