The CHC Checklist is the first formal step in the CHC assessment process. It's a brief screening tool — if your relative meets the threshold, the ICB must proceed to a full Decision Support Tool assessment. Crucially, anyone can request a checklist assessment; you don't need a referral, and you don't need to wait for a healthcare professional to raise it.

TL;DR: Anyone can request a CHC Checklist assessment — no GP referral is needed. Under the NHS Continuing Healthcare (Responsibilities) Directions 2013, your ICB must conduct a full DST assessment within 28 days if the threshold is met (2+ "A" scores, or 5+ "B" scores). Contact your local ICB's continuing care team directly — you can find your ICB here.

Step 1: What does the CHC Checklist screen for?

The CHC Checklist looks at 11 areas of need. A person meets the threshold if they:

Score two or more "A" (high need) responses, or
Score five or more "B" (moderate need) responses, or
Score one "A" and four "B" responses

If the threshold is met, the ICB must conduct a full DST assessment — usually within 28 days under standard CHC (NHS National Framework, 2022).

If your relative is approaching end of life or their condition is deteriorating rapidly, request fast-track CHC instead. Fast-track bypasses the checklist entirely: a clinician certifies that a severe, rapidly deteriorating condition makes a standard assessment inappropriate, and the ICB must arrange an urgent assessment within 48 hours. Speak to your relative's GP or consultant about whether fast-track criteria apply.

Not sure if your relative meets the checklist threshold? Use our free CHC eligibility screener for an indication in under 2 minutes.

Step 2: Who do you contact to request a CHC Checklist assessment?

The checklist request goes to the Integrated Care Board (ICB) responsible for your relative's area. You can find your ICB at:

Find your local ICB

The relevant team is usually called the "CHC team" or "continuing care team". Their contact details are on the ICB website.

Step 3: How do you write and send your CHC Checklist request?

Download the Checklist Screening Request template (linked in the sidebar). Send it:

By email (with read receipt) to the CHC coordinator
Or by recorded post to the ICB's registered address

The letter formally requests that a CHC Checklist be completed for your relative under the NHS Continuing Healthcare (Responsibilities) Directions 2013. Keep the proof of sending — if the ICB later claims they didn't receive a request, you'll need it.

Step 4: What should you do if the ICB does not respond?

The ICB should acknowledge your request within 5 working days. If you hear nothing within 10 working days:

Send a follow-up email referencing your original request date
Copy in the ICB's chief nurse if still no response

If the ICB continues to delay without explanation, you can escalate to NHS England. Unreasonable delays in progressing a CHC assessment are a breach of the Directions.

Step 5: How should you prepare for the CHC Checklist screening?

When the checklist is scheduled, gather brief notes on your relative's needs across the 11 areas. You don't need extensive evidence at this stage — the checklist is a screening tool — but having concrete examples ready will help ensure the scoring is accurate.

Attend the checklist screening in person if at all possible. You'll have the opportunity to describe needs the assessor may not be aware of from the records alone.

Once the checklist passes, the ICB has 28 days to hold a full DST assessment. Use this window purposefully:

Request your relative's GP and hospital records immediately via Subject Access Requests (see How to Obtain Medical Records) — organisations have 30 days to respond, so there's no time to wait
Begin drafting your Family Statement of Needs
Work through our assessment preparation guide

The 28-day window moves fast. Treat the date the checklist passes as day one of your preparation.

Step 6: What if the checklist result is below threshold?

If your relative scores below threshold and you believe this is wrong, you can request a review of the screening decision before a full DST assessment is ruled out.

Put your challenge in writing to the ICB's CHC team within 10 working days. Explain which areas you believe were understated and provide brief supporting evidence — a medical letter, a care home incident log, or your own written account. If the ICB maintains the below-threshold outcome, you can escalate your complaint to NHS England.

A below-threshold result doesn't permanently close the door. If your relative's condition changes or deteriorates, you can request a new checklist at any time. There is no minimum waiting period between requests.

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