How to prepare for the NHS Continuing Healthcare process: from Checklist to full assessment

If you are arranging care for someone, or trying to understand what support they may be entitled to, the NHS Continuing Healthcare process can feel confusing at first.

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You may be dealing with a social worker visit, a care review, a hospital discharge meeting, a move into a care home, or a change in someone's needs. You may also have heard NHS Continuing Healthcare mentioned and be wondering what it means, where to start, and what information you need to prepare.

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Families often already have useful information somewhere: in letters, reports, appointment notes, care plans, emails, medication records and day-to-day observations. The difficult part is pulling it all together clearly, especially when the process is unfamiliar and decisions may affect future care and funding.

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NHS Continuing Healthcare, often called CHC, is not usually decided in one step. For many people, the process starts with an initial NHS Continuing Healthcare Checklist. If that Checklist is positive, the person may then move on to a full assessment using the NHS Continuing Healthcare Tool, also known as the Decision Support Tool.

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This is where Zone Scribe can help.

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Zone Scribe gives families a secure place to organise documents, notes and examples before meetings and assessments, so they are not trying to remember everything on the day.

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Where the Checklist and NHS Continuing Healthcare Tool fit in

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The NHS Continuing Healthcare process usually has two key stages.

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Stage 1: NHS Continuing Healthcare Checklist

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The NHS Continuing Healthcare Checklist is the initial screening stage.

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It is used to help decide whether someone should be referred for a full assessment of eligibility for NHS Continuing Healthcare.

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A Checklist may be completed when someone is:

• leaving hospital
• moving into a care home
• receiving care at home
• having a care review
• experiencing a change in their needs
• already receiving support, but their needs appear to be increasing

The Checklist does not decide whether someone will receive NHS Continuing Healthcare funding. It decides whether their needs should be looked at in more detail through a full assessment.

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Stage 2: NHS Continuing Healthcare Tool / Decision Support Tool

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If the Checklist outcome is positive, the person should usually move on to a full assessment.

This is where the NHS Continuing Healthcare Tool / Decision Support Tool is used. A multidisciplinary team looks at the person's health and social care needs in more detail and considers whether they have what is known as a primary health need.

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A simple way to understand the process is:

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In simple terms:

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Checklist = should there be a full assessment?

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NHS Continuing Healthcare Tool / Decision Support Tool = does the person qualify for NHS Continuing Healthcare?

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Why preparation matters

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These meetings and assessments can feel stressful, especially if you are trying to explain someone's needs while also managing their care.

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Even when you know the person well, it is easy to forget important details. Some needs may only happen at certain times of day. Some risks may not be obvious in a short meeting. Some difficulties may not appear clearly in formal records.

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Important information may be spread across:

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• hospital letters
• GP records
• care plans
• medication lists
• appointment notes
• social worker records
• family notes
• emails
• assessments
• care home updates

Good preparation helps you explain the person's needs clearly and gives professionals a fuller picture of what support is actually required.

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How Zone Scribe helps at each stage

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Zone Scribe helps families prepare for both parts of the NHS Continuing Healthcare process.

You can use Zone Scribe before the NHS Continuing Healthcare Checklist to organise key information about the person's needs.

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If the Checklist is positive, you can then use Zone Scribe to prepare more detailed information for the full assessment using the NHS Continuing Healthcare Tool / Decision Support Tool.

This means you can gather the person's story in one place, including documents, dates, examples, risks and family observations.

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NHS Continuing Healthcare Tool / Decision Support Tool preparation template

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Preparing for the NHS Continuing Healthcare Checklist

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The Checklist is usually the first formal screening stage for a new applicant.

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At this stage, the aim is to make sure the person's needs are clearly understood, so the Checklist reflects the reality of their day-to-day care.

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Using Zone Scribe, families can prepare a short summary of:

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• what support the person needs each day
• what has changed recently
• what risks exist if support is not provided
• what professionals or services are already involved
• what documents help show the level of need
• examples of difficult days, incidents or deterioration
• family observations that may not appear in formal records

This can help you feel more prepared if a nurse, social worker, care home, hospital team or other professional is completing the Checklist.

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Read the official GOV.UK CHC Checklist guidance

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Preparing for the full NHS Continuing Healthcare assessment

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If the Checklist is positive, the person may move on to the full NHS Continuing Healthcare assessment.

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This is where the NHS Continuing Healthcare Tool, also known as the Decision Support Tool, is used.

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The full assessment looks in more detail at areas such as:

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• breathing
• nutrition
• continence
• skin
• mobility
• communication
• psychological and emotional needs
• cognition
• behaviour
• medication
• altered states of consciousness
• other significant care needs

The full assessment is not just about listing diagnoses. It is about explaining the person's actual needs, what support they require, what happens without that support, and how their needs affect each other.

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Using Zone Scribe, families can start organising:

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• a short summary of the person's situation
• key changes over time
• important supporting documents
• notes on day-to-day care needs
• examples of risks, incidents or unmet needs
• observations from family members and carers
• questions they want to raise in the meeting

The NHS Continuing Healthcare Tool gives the formal assessment structure. Zone Scribe helps families gather and organise the information that may support the discussion.

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NHS Continuing Healthcare Tool / Decision Support Tool preparation template

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Read the official GOV.UK Decision Support Tool guidance

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How to use Zone Scribe to prepare your CHC information

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Zone Scribe helps you bring your information together before you use either the NHS Continuing Healthcare Checklist preparation template or the NHS Continuing Healthcare Tool / Decision Support Tool preparation template.

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The process is simple.

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1. Upload the relevant information into Zone Scribe

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Start by uploading the documents, notes and records that may help explain the person's care needs.

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This could include:

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• hospital discharge letters
• GP letters
• care plans
• medication lists
• social worker notes
• care home records
• risk assessments
• appointment letters
• emails with professionals
• family notes and observations
• examples of incidents, deterioration or unmet needs

The aim is to create one secure place where the important information is stored, instead of having it spread across folders, emails, paper records and different family members.

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2. Add your own notes and examples

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Formal records do not always show the full picture.

You can also add your own notes about what is happening day to day, including:

• what support the person needs
• what happens if support is not provided
• how often problems occur
• whether needs are getting worse
• risks around falls, nutrition, medication, behaviour, confusion or personal care
• examples of difficult days or incidents

This helps make sure the person's needs are described clearly and in practical terms.

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3. Choose the right template from the Zone Scribe Marketplace

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Once your information is uploaded, go to the Zone Scribe Marketplace and choose the template that matches the stage you are preparing for.

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Use the NHS Continuing Healthcare Checklist preparation template if you are preparing for the first screening stage.

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Use the NHS Continuing Healthcare Tool / Decision Support Tool preparation template if the person has had a positive Checklist and is moving on to the full assessment.

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NHS Continuing Healthcare Tool / Decision Support Tool preparation template

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4. Let the template help pull the information together

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The template helps turn the information you have uploaded into a more structured preparation document.

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It can help you pull together:

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• key background information
• relevant documents and dates
• examples of daily care needs
• risks and concerns
• changes over time
• family observations
• questions to raise with professionals
• points that may be relevant to the Checklist or full assessment

This means you are not starting from a blank page or trying to remember everything during the meeting.

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5. Review, edit and use it to prepare

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Once the template has helped organise the information, you can review it, edit it and add anything that is missing.

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You can then use the prepared document to:

• organise your thoughts before the meeting
• share relevant points with family members
• prepare questions for professionals
• check whether key evidence has been included
• feel more confident that important details are not missed

Zone Scribe does not replace the NHS process or make the eligibility decision. It helps families prepare for the process by organising their own information clearly, securely and in one place.

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Start with what you already have

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If you are at the beginning of the care support process, you do not need to have everything perfectly organised before you start.

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Begin with what you already have: letters, care notes, appointment records, medication information, family observations and examples of what is happening day to day.

Zone Scribe helps you bring that information together, then use the right template for the stage you are at.

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Whether you are preparing for the first NHS Continuing Healthcare Checklist or the full NHS Continuing Healthcare Tool / Decision Support Tool assessment, having your information organised can help you feel clearer, calmer and better prepared.

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Start preparing with Zone Scribe

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Official sources used

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• NHS: NHS Continuing Healthcare
• GOV.UK: NHS Continuing Healthcare Checklist
• GOV.UK: Checklist guidance
• GOV.UK: NHS Continuing Healthcare Decision Support Tool
• GOV.UK: Decision Support Tool guidance
• GOV.UK: National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care
• GOV.UK: Public information leaflet