NHS Continuing Healthcare Decision Support Tool tips

NHS Continuing Healthcare Decision Support Tool tips

NHS Continuing Healthcare Decision Support Tool tips

Unhappy with your latest assessment? These NHS Continuing Healthcare Decision Support Tool tips will help you.

If you’ve had an assessment for NHS Continuing Healthcare and you:

  • disagree with what assessors have written in the NHS Continuing Healthcare Decision Support Tool or Checklist


  • disagree with the NHS Continuing Healthcare funding recommendation


  • believe the process that assessors followed was incorrect

…here’s some advice to help you:

We’ve written many articles about the appalling failings in NHS Continuing Healthcare assessments and funding decisions, and we share lots of tips on our website to help families going through the NHS Continuing Healthcare assessment and appeal process.

Some of those articles include:

How to stand your ground in an NHS Continuing Healthcare assessment

How to prepare for an NHS Continuing Healthcare assessment

How to appeal an NHS Continuing Healthcare funding decision

There’s one vital thing to remember at all times during this process:

Just because an assessor states something as fact doesn’t mean it’s correct!

When someone in authority gives you information, it can feel uncomfortable questioning it. After all, they’re supposed to know what they’re talking about aren’t they?

Unfortunately there’s a whole heap of misinformation that families are given when to comes to NHS Continuing Healthcare.

On the same note, just because someone in authority sounds confident in what they say, doesn’t mean they’re right. And, similarly, if someone in an NHS Continuing Healthcare assessment meeting speaks to you in a condescending or intimidating manner, doesn’t mean that you are wrong.

Many families report that some assessors are aggressive in assessment meetings, including (wrongly) telling families they’re not allowed to speak or contribute. This is an appalling abuse of power.

Indeed, the National Framework guidelines make it very clear that family input is vital.

Families also report assessors ignoring evidence of care needs and, in so doing, reducing the chances of the person being assessed receiving the NHS Continuing Healthcare funding they’re entitled to.

It can be very hard to challenge someone face-to-face when that person is the ‘professional’. However it’s important that you do challenge everything you believe to be wrong or misleading in an NHS Continuing Healthcare Decision Support Tool and in the assessment process in general.

Rather than simply telling the assessor they’re wrong, you could instead say:

“The National Framework makes it very clear that…”


“As your own guidelines state, this is in fact not the case…”

By doing that, you’re simply pointing them to their own guidelines. It can make it a bit easier. To do this you obviously need to have read the guidelines yourself and know them well – ideally before the assessment process even begins.

The better informed you are yourself, and the better you know the assessment guidelines and the law, the better chance you have of getting things done properly and holding the assessors to account. The NHS Continuing Healthcare Decision Support Tool tips below will help you.

Families report that when they do find the courage to disagree with assessors and challenge them on their statements – and the assessors realise the family might know more than they do – things often start being done properly.

Families shouldn’t be put in this position, of course, but sadly it’s a situation that many face.

So to give yourself the best chance of getting the right outcome with an NHS Continuing Healthcare Decision Support Tool or any other stage…

NHS Continuing Healthcare Decision Support Tool tips:

  1. Give yourself time to read the guidelines properly – so you understand the process that should have been followed and the eligibility criteria.*
  2. Make sure you also read about the Coughlan case and the Grogan case.
  3. Keep a note of everything you know has been done incorrectly right from the very start, including where people have asked you about your relative’s money and/or told you your relative will automatically have to pay for their own care.
  4. Take time to pull together as much information as you can about your relative’s care needs and risks. Keeping a detailed diary can help a lot – even if it feels as though you’re writing down the most trivial things. It can all count.
  5. Make sure the correct evidence is reviewed during assessments and appeals – and that members of the multidisciplinary team who carry out the full assessment using the NHS Continuing Healthcare Decision Support Tool include all of this evidence in reaching their funding recommendation.
  6. Go through the NHS Continuing Healthcare Decision Support Tool yourself, so you know what the scores should be in each ‘domain’. Be ready to back up what you’re saying.
  7. If you’re right at the start of the NHS Continuing Healthcare assessment process, familiarise yourself with the Checklist and the things that can go wrong at this stage.

(* Many people question whether the National Framework guidelines are in themselves lawful, as they could be considered a barrier to NHS healthcare/nursing care. We can certainly understand that point of view; at the same time, the National Framework and the NHS Continuing Healthcare Decision Support Tool and Checklist are the processes that people right now are being made to follow.)

You’ll find an outline of all the stages of the NHS Continuing Healthcare assessment process here.

If you’re unhappy with the NHS Continuing Healthcare Decision Support Tool that’s been completed for your relative and/or you’re unhappy with the funding recommendation made, be sure to appeal.

If you need someone to help you, an initial chat – free of charge – with a specialist can be useful in the first instance. Read more here.


  1. Linda Bateman 5 months ago

    My mother in law has just had the initial checklist completed during her hospital stay and has been put forward for a full CHC assessment. However we strongly feel that she has been “downgraded” in a couple of areas but no one seems to be listening to our concerns. Can we challenge the checklist?

    Any help gratefully received!

  2. Sally 11 months ago

    What is the elibility for NHS Funded Nursing Care (FNC) as opposed to NHS Continuing Healthcare (CHC)? I don’t think my Mum is eligible for CHC funded but I do think she has nursing needs, but the CHC assessment decided she didn’t have any nursing needs and therefore won’t pay the FNC top up at her nursing home. They have told us she should be in a Residential Care home. We strongly disagree with this but don’t know how to challenge it as we don’t know the nursing needs eligibility criteria. Can anyone help?

  3. Mark 12 months ago

    I’ve been battling with the hospital for some time, but now had the Decision Support Tool (DST) completed. My brother and i have been fully involved but the in the Multidisciplinary Team (MDT) meeting, the team refused to consider my mothers situation in the event of the antipsychotic (Risperidone) being withdrawn / unavailable.
    We argued that’s incorrect due to paragraph 28 in the DST guide notes.
    Paragraph 29 however slightly contradicts 28. Any clarification on how the two paragraphs / notes should be applied would be hugely appreciated.
    Mum has scored severe in cognition and hence if she scores severe in behaviour, as we believe she has to be classed as eligible.
    I feel we are being hoodwinked and cheated.
    All the best

  4. Chris 12 months ago

    One further question regarding oral hygiene
    Where in the national framework is oral hygiene not relevant to NHS Continuing Healthcare funding?
    Lack of oral hygiene due to non compliance etc will potentially cause gum disease, thrush (and has done ), and tooth decay
    The Assessor completely dismissed it as a health/care issue saying that was purely under the banner of social care only.

  5. Chris 12 months ago

    My Mother has been receiving NHS Continuing Healthcare (CHC) funding for the last 2 years and today I attended a review and the recommendation is to now remove the funding, but would like your opinion on the following :-

    1) No-one from the Local Authority turned up; the Multidisciplinary Team was a RGN and Registered Mental Health Nurse (RMN).
    2) I have to feed my Mum daily (teatimes) because the care home does not get anywhere near enough food in her (spits out, refuses etc but never with me).
    3) I know my Mother responds to my voice and not visually anymore and the Assessor agreed with that — his only suggestion was to try with a voice recording and see how that goes (what utter *****).
    4) She scored 1 x Severe and 4 Highs and 2 Moderates, but it came down to the 4 key indicators, and in their opinion that is not deemed as intense or complex or anything.

Leave a reply

Your email address will not be published. Required fields are marked *


2100 characters max. All comments are moderated in line with our Acceptable Use Policy and our Terms of Website Use.