How-To Guide

How to Prepare for a CHC Assessment Meeting

The MDT meeting determines CHC eligibility across 12 care domains. Know what to bring, what to say, and how the DST scoring works — so you walk in ready.

The Multi-Disciplinary Team (MDT) meeting is where your relative's eligibility for CHC is decided. Preparation makes a significant difference to the outcome. Families who arrive with specific written evidence — rather than general observations — are far better placed to challenge scores they disagree with and get those disagreements on record.

TL;DR: The Multi-Disciplinary Team uses the Decision Support Tool (DST) to score needs across 12 care domains. Bring specific written evidence — incident dates, care records, and a Family Statement. Under the NHS National Framework (2022), you have the right to attend, speak, be accompanied, and challenge scores during the meeting. If you disagree with the outcome, you can request local resolution within 6 months.

Step 1: What is the Decision Support Tool and how does it work?

The MDT uses the Decision Support Tool (DST), established under the NHS National Framework for CHC (2022). It scores your relative across 12 care domains:

Behaviour, Cognition, Psychological/Emotional, Communication, Mobility, Nutrition, Continence, Skin (tissue viability), Breathing, Drug Therapies, Altered States of Consciousness, and Other Significant Care Needs.

Each domain is scored: No needs, Low, Moderate, High, Severe, or Priority. Priority in any domain or Severe in multiple domains is strong evidence for CHC eligibility.

For a detailed explanation of what each domain covers and how to build evidence for it, see our 12 Care Domains guide.

Step 2: What evidence should you bring to the MDT meeting?

Bring to the meeting:

  • Copies of key medical records (see How to Obtain Medical Records)
  • A completed Family Statement of Needs (see how to write one)
  • Your daily care diary (if you have been keeping one)
  • Any letters from GPs, consultants, or specialists describing your relative's needs
  • A list of current medications with dosages
  • A written summary of the specific domain scores you believe are understated, with your evidence for each

That final item is the one most families skip. Don't. It turns a general conversation into a structured challenge that assessors must address and document.

Step 3: What are your rights at the MDT meeting?

Under the NHS National Framework (2022), you have the right to:

  • Attend the full MDT meeting — not just a brief slot at the end
  • Speak and provide your view on each domain as it is scored
  • Be accompanied by an advocate, friend, or representative
  • See each domain score before the meeting concludes
  • Request written confirmation of the outcome and the reasons

Use all of these rights. If the ICB tries to restrict your participation — for example by limiting you to a brief window at the end — politely but firmly refer to the National Framework's requirement for family involvement throughout the assessment process.

Before you leave, ask for a note of the scores awarded in each domain. If the assessors won't provide this on the day, submit a written request for the completed DST within 24 hours of the meeting. You are entitled to a copy.

Step 4: How should you advocate for your relative during the MDT meeting?

Specific examples are far more effective than general descriptions. "On 14 March she had three episodes of distress requiring one-to-one intervention" is stronger than "she often gets distressed." Keep the date, the event, and the required response together in one sentence.

Watch for the "well-managed needs" argument. Assessors sometimes score a domain as Moderate rather than High because needs appear stable. But stability that depends on intensive care input doesn't mean the underlying need is low — it means the care package is working. The NHS National Framework requires assessors to consider the nature, intensity, complexity, and unpredictability of needs even when they're being actively managed. If you hear a score being justified on the basis that "things are under control," push back and ask what would happen if that level of care were removed. Then provide the incident history that answers that question.

During the meeting:

  • Ask assessors to explain each domain score before accepting it
  • If a score is lower than you believe is accurate, say so politely and provide your evidence
  • Ask for your disagreement and the assessor's reasoning to be recorded in the minutes

Download the MDT Meeting Preparation template (linked in the sidebar). It covers specific questions to ask about the scoring process and how to challenge a score in the room.

Step 5: What if you disagree with the CHC assessment outcome?

If the MDT recommends against CHC, you don't have to accept this. You have the right to:

  1. Request a copy of the completed DST
  2. Seek local resolution (see How to Appeal a CHC Decision)
  3. Escalate to an Independent Review Panel (IRP)

Ask at the end of the meeting for written confirmation of the decision and the process for challenging it. The local resolution window is six months from the date of the decision — but acting quickly while the meeting is fresh gives you the clearest record to work from.

If you feel the assessment was rushed, that you weren't given adequate time to present your evidence, or that the scoring didn't reflect what was discussed in the meeting, note this explicitly in your local resolution request. Process failures matter as much as scoring errors.

Sources: NHS National Framework for CHC and NHS-Funded Nursing Care (2022) | NHS.uk — Continuing Healthcare

Free CHC eligibility check