Based on the 2022 NHS National Framework

NHS Continuing Healthcare Eligibility Checker

Answer 10 quick questions about your parent's care needs to find out whether it's worth requesting an NHS Continuing Healthcare (CHC) assessment. Free, anonymous, no sign-up. Built and reviewed by a UK care-sector professional.

England only: NHS Continuing Healthcare is an England-only scheme. If your parent lives in Wales, Scotland or Northern Ireland the rules and the name of the scheme are different and this quiz will not give accurate guidance.

For each question, pick the answer that best describes your parent right now. If you're unsure between two options, pick the higher one — the official assessment also accounts for fluctuating needs.

1. How does your parent breathe? — Breathing domain

2. How does your parent manage eating and drinking? — Nutrition domain

3. How is your parent's continence (bladder and bowel)? — Continence domain

4. Does your parent have skin or pressure-area problems? — Skin and tissue viability domain

5. How mobile is your parent? — Mobility domain

6. How well can your parent communicate their needs? — Communication domain

7. Does your parent show distress, anxiety, depression or mood disturbance? — Psychological & emotional needs

8. How is your parent's memory and decision-making? — Cognition domain

9. Does your parent show challenging or risky behaviour? — Behaviour domain

10. Does your parent need complex medication or experience seizures / loss of consciousness? — Drug therapies + Altered states

0 of 10 answered

Important: This quiz gives a guide only. It is not a clinical assessment and cannot determine NHS CHC eligibility. Only a multidisciplinary team using the official Decision Support Tool can do that. If your parent has any significant health needs, you can request a Checklist screening from their GP, district nurse, hospital ward (especially before discharge), social worker, or the local Integrated Care Board.

Worked example: Robert, 79, vascular dementia + recurring infections

Robert is 79. He has vascular dementia, is doubly incontinent, and has had three chest infections in the past six months requiring district-nurse antibiotic visits. He has fallen twice in the last month and is now bed-bound, requiring two carers and a hoist for every transfer. He recognises his daughter but can't reliably tell carers when he's in pain.

His daughter completes the quiz on Robert's behalf. Here's how his answers map:

Breathing: Moderate (occasional breathlessness from infections) → M
Nutrition: Moderate (needs help with meals) → M
Continence: High (doubly incontinent, complex management) → H
Skin: Moderate (at risk; uses pressure mattress) → M
Mobility: High (hoist-dependent, two-carer transfers) → H
Communication: Low (some difficulty but copes with familiar people) → L
Psych & emotional: Moderate (frequent distress with infections) → M
Cognition: High (significant dementia, no safety awareness) → H
Behaviour: Moderate (occasional agitation) → M
Drugs / altered states: High (recurring antibiotic visits, IV input) → H

Counts: 0 Priority, 0 Severe, 4 High, 5 Moderate, 1 Low.

Result: "Worth requesting a CHC Checklist." Robert doesn't hit the automatic-eligibility triggers (1+ Priority or 2+ Severe). But the National Framework explicitly says combinations like "a number of domains with High and/or Moderate needs" can also indicate a primary health need — the multidisciplinary team must judge holistically. Cases like Robert's are exactly why families should push for a Checklist rather than self-rule out.

What is NHS Continuing Healthcare?

NHS Continuing Healthcare (CHC) is a package of care that the NHS pays for in full when an adult is assessed as having a "primary health need". Unlike local authority social care, it is not means-tested — your parent's savings, income and property are irrelevant. If they qualify, the NHS pays for the entire care package, whether at home, in a care home or in a nursing home.

CHC is funded and arranged by the local Integrated Care Board (ICB), which replaced Clinical Commissioning Groups (CCGs) under the Health and Care Act 2022. The rules are set out in the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, last revised in July 2022 (with corrections in July 2023).

Who is eligible? The "primary health need" test

Eligibility doesn't depend on a single diagnosis. It depends on whether the person's overall care needs are primarily about health, rather than primarily about social care. The National Framework uses four characteristics — taken together — to identify a primary health need:

Nature — the type of needs and the kind of intervention required to manage them.
Intensity — the extent and severity of the needs and how much support is required.
Complexity — how the needs interact and the level of skill required to manage them.
Unpredictability — how much the needs fluctuate, and the risk if care is not provided promptly.

If the cumulative picture across these four shows a level of need that goes beyond what a local authority can lawfully provide, the NHS becomes responsible.

The assessment process: Checklist → Decision Support Tool → ICB decision

There are two stages.

1. The Checklist (screening). This is a short tool completed by any trained health or social care professional — most often a GP, community nurse, hospital discharge team or social worker. It rates each care domain as A, B or C. Per the official Checklist guidance on gov.uk, a referral for full assessment is required if the person scores 2 or more A's, 5 or more B's, 1 A + 4 B's, or any single A in a "priority" box (the asterisked rows). The Checklist is a low bar — it is meant to filter out only the people with clearly minimal needs.

2. The Decision Support Tool (DST). If the Checklist is positive, a multidisciplinary team (MDT) of at least two professionals from different healthcare disciplines completes the full DST. They score the person across 12 care domains: breathing; nutrition; continence; skin and tissue viability; mobility; communication; psychological and emotional needs; cognition; behaviour; drug therapies and medication; altered states of consciousness; and other significant care needs. Each domain is rated as no needs, low, moderate, high, severe or priority — though not every domain has every level available.

3. The eligibility rule. A clear recommendation of eligibility is expected where there is either a "priority" level need in any of the four domains that carry that level (breathing, behaviour, drug therapies, altered states of consciousness), or two or more "severe" needs across all domains. Eligibility may also be indicated by combinations of one severe with several highs, or many high or moderate scores — but those cases require professional judgement by the MDT.

4. The ICB decision. The MDT makes a recommendation; the Integrated Care Board makes the final decision and "should usually accept" the MDT's recommendation. The whole process from referral to decision should normally take no more than 28 calendar days.

Common reasons CHC applications fail

The Parliamentary and Health Service Ombudsman has repeatedly flagged similar themes in upheld CHC complaints. The most common pitfalls:

Checklist scores not supported by the medical record. Under-scoring at screening stage means the person never reaches a full DST. Always check the Checklist scores against your parent's actual care notes and challenge anything that looks low.
Care plans not produced or not reflecting the real picture. Without a written care plan that captures the daily reality, the MDT has nothing concrete to assess.
"Well-managed needs" being scored down. A need that is currently controlled by skilled care is still a need. The framework is clear that needs should be assessed as they would be without that intervention.
MDT not properly convened. The DST requires at least two professionals from different healthcare disciplines. Decisions made by a single assessor or by professionals from only one discipline can be challenged.
Family not consulted. Families have a right to attend the DST meeting and submit evidence. Push back if you are excluded.

How to request a Checklist

You don't need a special form. Ask any of the following:

Your parent's GP — particularly useful if you've noticed a recent decline.
The hospital ward or discharge team if your parent is in hospital — this is the strongest moment to request screening, before discharge planning concludes.
The district nurse or community matron if one is involved.
The social worker if one has been allocated.
The local ICB's CHC team directly — search "[your area] ICB continuing healthcare" online.

If a Checklist has been done before and your parent's needs have since worsened, you can request a fresh one. There is no limit on how many times a Checklist can be completed.

How this checker works (methodology)

This checker mirrors the official scoring rule in the National Framework's Decision Support Tool, applied to a 10-question summary covering all 12 care domains:

Each question maps to one domain (with question 10 covering both Drug therapies and Altered states of consciousness).
Each answer option is graded N (no needs), L (low), M (moderate), H (high), S (severe), or P (priority) — but only the levels that domain actually has in the official Framework. For example, Continence and Communication have no "Severe" level; Altered states of consciousness has no "Severe" but does have "Priority".
The recommendation engine applies the official rules: 1+ Priority in any of the four priority-bearing domains or 2+ Severes across all domains triggers "Request a Checklist now". Combinations that "may indicate" eligibility (1 Severe + multiple Highs, or several Highs and Moderates) trigger "Worth requesting". Anything below that triggers "Unlikely on these answers".
The output language is deliberately probabilistic — only an MDT can determine actual eligibility. A real DST also considers Nature, Intensity, Complexity and Unpredictability holistically, not just severity counts.

How to use this checker

Pick the answer that best describes your parent right now. If their needs fluctuate, pick the higher option — the official assessment also accounts for unpredictability.
Be honest about "well-managed" needs. If your parent currently has no pressure ulcers because skilled carers turn them every two hours, that's still a high-level skin need — score it as H, not N.
Answer all 10 questions then click "See result".
Read the result and the next-steps box. If the result says "Request a Checklist now" or "Worth requesting", screenshot or print the page and bring it to the GP or social worker as evidence of your concerns.

What's NOT included in this checker

Clinical assessment. This is a self-assessment based on a non-clinician's observations. It cannot replace the official DST, which is completed by a multidisciplinary team with access to medical records.
The Checklist itself. This checker simulates the DST scoring rules, not the Checklist's A/B/C scoring. Only a trained professional can complete the official Checklist.
Fast Track route. If your parent's condition is rapidly deteriorating and may be entering a terminal phase, ask immediately about Fast Track CHC — a separate accelerated route that bypasses the Checklist and DST.
Devolved nations. NHS CHC is England-only. Wales, Scotland and Northern Ireland have separate (and different) schemes.
Cost calculations. If you don't qualify for CHC, use our UK Care Home Cost Calculator to estimate what care will cost under the means-tested system.
Appeals process. If your parent has been refused CHC, you can appeal — first to the ICB, then to NHS England, then to the Parliamentary Ombudsman. We don't currently have a dedicated appeals tool.

Why trust this checker

The questions, answer options, and scoring rules in this tool are mapped directly to the official 2022 National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, the published Decision Support Tool guidance, and the Checklist guidance — all linked inline above so you can verify. The methodology section explains exactly how answers map to recommendations.

The checker is reviewed by Hinesh Patel, owner-operator of Birkdale Village Care Home, with over a decade of UK care-sector experience including direct involvement in CHC Checklists, DST assessments, and appeals on behalf of residents and families. The tool is updated whenever the official Framework or DST guidance is revised.

Frequently asked questions

Is NHS Continuing Healthcare means-tested?

No. NHS CHC is completely separate from the local authority means test. It is awarded based on the nature, intensity, complexity and unpredictability of someone's health needs, regardless of their savings, income or property. If awarded, the NHS funds the full cost of care in any setting.

What is the NHS CHC Checklist and Decision Support Tool?

The Checklist is a short screening tool that decides whether someone should be referred for a full assessment. The Decision Support Tool (DST) is the full assessment, completed by a multidisciplinary team across 12 care domains. Only the DST can determine eligibility — the Checklist just opens the door.

How long does the NHS CHC assessment process take?

The NHS National Framework sets a 28-day target from referral to eligibility decision. In practice it often takes longer. If the ICB exceeds 28 days without good reason, care costs from day 29 onwards can be reclaimed.

What is the difference between CHC and NHS-funded Nursing Care?

NHS Continuing Healthcare covers the full cost of care for people with a primary health need. NHS-funded Nursing Care (FNC) is a smaller flat-rate weekly contribution toward registered nursing in a nursing home — £267.68 per week (2026/27 standard rate in England) — paid when someone is not eligible for full CHC but still needs nursing input.

Does this quiz apply to Wales, Scotland or Northern Ireland?

No. NHS Continuing Healthcare is an England-only scheme. Wales has its own Continuing NHS Healthcare framework, Scotland has Hospital Based Complex Clinical Care, and Northern Ireland has separate continuing healthcare arrangements through HSC Trusts. The eligibility rules are different in each nation.

Can I appeal an NHS CHC decision?

Yes. First request a local resolution review from the Integrated Care Board (ICB). If unresolved, escalate to NHS England for an Independent Review Panel. Final escalation is to the Parliamentary and Health Service Ombudsman. Many initially-refused cases are overturned at the review stage.

What is Fast Track CHC?

Fast Track is a separate route for people with a rapidly deteriorating condition that may be entering a terminal phase. A clinician completes the Fast Track tool and the ICB should arrange care normally within 48 hours. No Checklist or DST is needed.

Can my parent have CHC and pay for top-ups?

If your parent is eligible for CHC, the NHS must fund the full assessed care package — there should be no top-up. In practice, families sometimes pay third-party top-ups for additional comforts (a private room in a particular home of choice, extra trips out). This is permitted, but the NHS should never refuse to fund what your parent's assessed needs require. Push back firmly if a CHC package is being framed as "CHC plus a required top-up" — that's not how the Framework works.

What evidence should I gather before the CHC assessment?

Bring: GP records and recent letters; hospital discharge summary if applicable; medication list including PRN/as-needed drugs; care plan from the current care provider; daily care logs from the last three months if available; falls and incidents log; district nurse visit notes; family observations of the unpredictable, fluctuating, or distressing aspects of care that staff might not see in a single visit. The MDT can only score what they can see evidenced — your job is to make the picture complete.

Reviewed by Hinesh Patel, with over a decade of experience in the UK care sector.

Last reviewed: May 2026 · Next review due: May 2027

Last updated: May 2026. Sources: NHS CHC Decision Support Tool guidance (gov.uk); National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, July 2022 (gov.uk); NHS CHC Checklist guidance (gov.uk); NHS.uk public information; Parliamentary and Health Service Ombudsman reports.