Start with the highest domain scores in NHS Continuing Healthcare

Start with the highest domain scores in NHS Continuing Healthcare

Domain scores in NHS Continuing Healthcare - focus with magnifying glassDon’t let assessors review the lowest scores first in NHS Continuing Healthcare assessments

Tip no. 21 in our series of 27 top tips on NHS Continuing Healthcare…

In the two-stage assessment process for NHS Continuing Healthcare, assessors look at a number different care domains.

These domains relate to different aspects of need, e.g. Behaviour, Mobility, etc. Each individual domain is given a score.

In the Checklist assessment for NHS Continuing Healthcare (stage one), the scores for each domain are either A, B or C. C is the lowest.

Some families report that assessors will look at the C scores first, to see if the person’s care needs fit that lowest score, and that they will stay focused on the lowest scores first in each domain.

Why focus first on the higher domain scores in NHS Continuing Healthcare?

It’s likely that anyone with a fair degree of care needs will almost certainly fit the lowest scores. However, by focusing attention on the low end of the scores, an obvious – and vital – higher score could be missed.

It’s far better to start with the highest score in each domain, i.e. A, and then work down to a lower score if needed.

This may sound like a trivial point, but it’s not – because when everyone’s focus has been placed on the low-end scores, it can be much harder to push for the higher scores you believe your relative actually deserves.

Exactly the same principle applies in the full multidisciplinary team assessment, where the scores for each domain range from No Needs and Low right up to Priority, with three others in between.

If an assessor is looking at whether a person fits the Low score, there may be a very good chance the person does – and yet a far safer way is to start much higher up the scale and work down if needed.

You can find a copy of the Checklist document (stage one) and the Decision Support Tool (stage two) on this page of the website.

Tip no. 20: Are there different levels of NHS care funding?

Tip no. 22: What to say when denied NHS Continuing Healthcare

You don’t have to fight this battle alone

Fighting a Continuing Healthcare funding battle alone can feel daunting. If you need to talk to someone about your case, read more here.


1 Comment

  1. Ray MCQUEEN 11 months ago

    I have a query that I would welcome comment on.
    My widowed father in law was diagnosed with dementia in 2014. He only has one child (my wife) and as we didn’t live near him, we took the decision to move him into a local care home where we could visit him regularly. He is self funding and so we applied for NHS Continuing Healthcare (CHC) funding. He is on various medications, including drugs for dementia and also anti depressants.
    The outcome of a Multidisciplinary Team/Decision Support Tool (after 24 months of NHS bureaucracy) meeting was that my father in law was eligible for NHS CHC. This decision was subsequently overturned by the clinical verification team, as they said my father in law’s healthcare needs were “incidental or ancillary to the provision of accommodation and that his needs were predominately for personal and social care”.
    Prior to living in the care home, my father in law was very depressed and suicidal. Owing to regular dosing of the anti depressants, and living in a 24/7 care environment, he no longer has suicidal thoughts.
    According to The National Framework for NHS Continuing Healthcare, “well managed needs are still needs”, and so I believe my father in law still has a case. We have have a preliminary appeal meeting with the relevant CCG and they have said the appeal will fail, ’cause he doesn’t have a need. Are they right?

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.