The Family Statement of Needs is your opportunity to describe, in your own words, what your relative's care needs actually look like day to day. Assessors read it before and during the MDT meeting — a well-written statement can shift a domain score from Moderate to High. A strong statement focuses on whether your relative has a primary health need, which is the legal test for CHC eligibility.
TL;DR: A well-written family statement can shift a CHC domain score from Moderate to High — assessors read it before and during the MDT meeting. Structure yours by each of the 12 DST domains, use specific incidents with dates, and focus on the worst days not the best. Aim for 500–1,000 words (roughly 2–4 pages). Submit at least 5 working days before the MDT to the ICB's CHC coordinator.
Step 1: Download the template and understand the format
Use the Family Statement of Needs template (linked in the sidebar). It guides you through each of the 12 CHC domains with prompts, so you don't miss anything important.
Aim for 500–1,000 words across the statement. Shorter than 500 words risks looking thin; longer than 1,000 can lose the assessor's attention on your key points. Two to four pages is the right length.
Write in plain English. Use present tense for current needs ("she requires one-to-one support when…") and past tense for specific incidents ("on 3 March, she fell while…"). You can also read our DST Evidence Builder guide for a full breakdown of what evidence works best in each domain.
Step 2: What should your family statement actually say?
The most effective statements are factual and specific. Compare these two approaches:
Weak: "Mum is very confused and it upsets the whole family."
Strong: "On a typical evening, Mum requires 30–40 minutes of reassurance. She doesn't recognise her home environment, frequently attempts to leave, and has twice required physical guidance away from the front door to prevent falls."
Assessors are looking for evidence of care need and frequency — give them both. Every claim should answer three questions: what happens, how often, and what does it take to manage it?
Step 3: What if your relative can't describe their own needs?
Most CHC cases involve someone whose condition limits their ability to describe their own experience. If your relative has dementia, has had a stroke, or otherwise can't communicate their needs, your statement fills that gap.
Write from the perspective of a careful observer. Describe what you see, what carers report, and what records show. You're not guessing at their internal experience — you're documenting observable facts: what triggers distress, what interventions are needed, how long they take, and how often they occur.
If professional carers have observed the same needs you've seen, ask them to provide a brief supporting letter. Care home staff are often willing to do this, and a consistent account from both family and professional carers carries significant weight at the MDT.
Step 4: How should you cover each of the 12 DST domains?
Work through the 12 DST domains in order. For each one, describe:
- What the need is
- How often it occurs
- What intervention or care is required when it occurs
- Whether professional input (GP, consultant, district nurse) has been needed
Don't leave any domain blank. Even where needs are low, write "no significant needs in this area" rather than leaving it empty — a blank domain can look like an oversight rather than a considered assessment.
Step 5: Why must you include specific incidents and dates?
List any hospital admissions, falls, infections, or crisis events from the past 12–24 months. Include dates where you can. These incidents demonstrate that needs are not being "managed" successfully — a principle established in the NHS National Framework (2022).
This matters because assessors sometimes argue that stable needs indicate a lower care requirement. The counter-argument: stability that depends on intensive, skilled care input is itself evidence of high need. If your relative's needs are only controlled because of a high-input care package, say so explicitly — "without the current care arrangement, these episodes would result in frequent falls/acute hospital admissions/crisis interventions." Then support that claim with the incident history.
Step 6: Close with the overall picture
End with a paragraph summarising the cumulative effect of all needs. For example:
"Taken together, Mum's needs require 24-hour supervision, specialist knowledge of managing severe dementia-related behaviours, and frequent unplanned interventions that go far beyond personal care. These needs are primarily a health need, not a social care need."
This framing directly addresses the Primary Health Need legal test and gives assessors the language to document eligibility if they agree.
Step 7: When and how should you submit your family statement?
Aim to submit your statement at least 5 working days before the MDT. This gives assessors time to read it and incorporate it into their domain scoring. Send it directly to the CHC coordinator at your ICB — by email with read receipt, or by recorded post.
Keep a copy of exactly what you sent and when. If the assessors claim at the meeting that they haven't seen it, you can produce the sent confirmation on the spot.
Once submitted, use our assessment preparation guide to get ready for the meeting itself.
Sources: NHS National Framework for CHC and NHS-Funded Nursing Care (2022) | NHS.uk — Continuing Healthcare