Understanding CHC in North East London
North East London's demography tells a story of rapid, uneven growth. Tower Hamlets saw the largest population increase of any London borough (+22.1% between 2011–2021) and is now home to one of the country's largest Bangladeshi communities. Newham grew by 14%, Waltham Forest by 7.8%, Hackney by 5.3%. This growth has not been matched by proportional investment in adult social care or CHC provision — creating bottlenecks in assessment scheduling and assessment team capacity that cascade into delays for families.
The ICB operates a place-based structure, with dedicated partnerships aligned to each of the eight boroughs. Theoretically this should create locally-responsive teams. In practice, families report inconsistent service quality depending on which borough team handles their case — some place partnerships are well-resourced and experienced, others stretched and reactive.
Health inequalities in North East London are acute and intersectional. The areas experiencing greatest population growth (Tower Hamlets, Newham, Waltham Forest) also experience the highest deprivation indices and largest populations of communities of colour. Bangladeshi, Caribbean, Eastern European, and African health beliefs, family care structures, and health literacy pathways often diverge significantly from the standardised assumptions embedded in the DST. A CHC assessment completed by an assessor unfamiliar with these cultural contexts risks systematic underestimation of complexity.
One bright spot: disability prevalence in Newham fell from 13.5% to 9.1% between 2011–2021 — the largest percentage-point improvement in the country. This suggests either genuine population-level health gains or improved access to employment and social participation. However, it also means CHC assessors in Newham may be calibrated to expect lower need levels. Complex cases involving disability require particularly robust evidence gathering.
CHC approval statistics for North East London
Source: NHS England official CHC statistics, 2024/25 · Rank 14 of 36 ICBs in England
Standard approval rate
16.1%
National avg: 19.5%
Assessments completed
1,761
283 found eligible
Fast-track approved
2,137
of 2,137 fast-track assessments
Local review requests
125
5.6% changed to eligible
Currently receiving CHC
1,218
Snapshot Q3 2025/26
England rank
14 / 36
1 = lowest approval rate
How North East London compares — 2024/25
Three-year approval rate trend
National average: 19.5% in 2024/25 · Source: NHS England
What this means
North East London's 16.1% approval rate sits broadly in line with the national average of 19.5%. Roughly 1 in 6 people assessed receives a positive decision via the standard route. The quality of evidence presented at the DST assessment remains the single most important factor within families' control.
How to apply for CHC funding in North East London
NHS Continuing Healthcare (CHC) is assessed and funded by your local Integrated Care Board. If you live in the North East Londonarea, here's what you need to know.
Step 1: Request a CHC screening
You can request a CHC Checklist screening at any time — in hospital, at home, or in a care home. Contact your GP or the North East London CHC team on 0345 548 0300 to start the process.
Step 2: The Checklist assessment
A healthcare professional will complete the CHC Checklist with you. If you score positively on two or more domains (or one domain at "priority" level), you'll be referred for a full assessment.
Step 3: The full Decision Support Tool assessment
A multidisciplinary team will carry out a comprehensive assessment using the Decision Support Tool (DST). This evaluates your needs across 12 care domains.
Advocacy tips for North East London
These tips are specific to applying for CHC in the North East London area.
action
Identify which of the eight place-based partnerships handles your case early — the service experience and assessment speed varies significantly between them. Ask your borough CHC team to confirm which partnership will lead your assessment.
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If the person needing CHC is from a Bangladeshi, Eastern European, Caribbean, or African background, proactively brief assessors on any health beliefs or family care practices that diverge from English norms. For example, if family members provide unpaid care due to cultural expectations, frame this as evidence of need intensity rather than assuming the assessor will understand it as such.
action
Barts Health, BHRUT, and Homerton are working jointly on urgent/emergency care, cancer, and planned care — this collaboration is positive for integrated assessment but can slow cross-trust communication. If your case involves multiple hospital trusts, request a single lead assessor for coordination.
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For mental health or psychological complexity claims, actively involve East London NHS Foundation Trust (ELFT) in evidence gathering. ELFT has strong dementia and mental health expertise across the region.
action
Tower Hamlets assessments are conducted by ELFT and Barts Health staff. Ensure evidence is sent to the correct CHC administrative centre for your borough — misdirected documentation sometimes gets lost.
Hospital trusts in North East London
These are the main NHS trusts whose patients may be assessed for CHC in this area. If your relative is being discharged from one of these hospitals, ask the ward about CHC screening.
Barts Health NHS Trust
Royal London Hospital, St Bartholomew's Hospital, Whipps Cross Hospital, Newham Hospital, Mile End Hospital
Homerton Healthcare NHS Foundation Trust
Homerton University Hospital
Whittington Health NHS Trust
Shared with North Central London services
East London NHS Foundation Trust
Mental health and assessment services (Tower Hamlets)
Barking, Havering and Redbridge University Hospitals Trust (BHRUT)
Community and acute services
Contact North East London
Frequently asked questions
I'm in Tower Hamlets. How do I request a CHC assessment?
Ask your GP, social worker, district nurse, or care home nurse for a Checklist assessment, or contact the Tower Hamlets Place Partnership directly via the NHS North East London website. Tower Hamlets assessments are provided by East London NHS Foundation Trust and Barts Health NHS Trust. Anyone can request a screening — you don't need a professional referral.
How should I evidence the 12 DST domains in North East London?
For each domain, provide: actual daily care logs showing frequency and intensity of need, references to medical records, risk assessments (falls, pressure ulcers, behaviour incidents with ABC charts), specialist reports (tissue viability, speech and language therapy, neurology, mental health), and evidence of 1:1 care provision. If the person's health narratives or care practices differ from standard English assumptions, include explicit framing — e.g., 'Family provides culturally-appropriate supervision due to [specific health need], not social preference.'
What's the difference between the Checklist and the DST?
**Checklist** (screening, 5–10 minutes): Completed by a variety of professionals, uses simple A/B/C scoring (high/moderate/low need). If high need is indicated, automatic referral for full assessment. **DST** (Decision Support Tool, full assessment, 1–2 hours): Completed by multidisciplinary team, uses detailed N/L/M/H/S/P scoring (none/low/moderate/high/severe/priority), assesses nature/intensity/complexity/unpredictability of health needs to determine 'primary health need' eligibility. Only DST is legally binding.
How long does CHC assessment take in North East London?
The Checklist outcome should be provided within 28 days of request. Full DST assessment timescales vary; aim is typically 28 days but complex cases take longer. If you exceed 3 months without a decision, escalate to your place partnership or the ICB central management team. During periods of high demand, assessment waiting times can extend significantly — document any delays.