The Checklist Format
This ‘assessment’ will look at 11 aspects or ‘Domains’ of your daily life and how they are affected by your medical conditions – we have added in some possible areas that might be considered under the heading of each Domain, though this is certainly not an exhaustive list.
Breathing – Asthma? COPD? Regular chest infections?
Nutrition – What you eat & drink? Any special dietary requirements? Speech and Language assessments? BMI? MUST Score?
Continence – Incontinent of urine or faeces? Incontinence pads? Catheter?
Skin – skin intact? Pressure areas? Regular creams applied?
Mobility – can you walk unaided? Falls history? Risk Assessment?
Communication – verbal/non-verbal? Glasses/hearing aids? BSL? Both expressive and receptive communication are important.
Psychological and Emotional – anxiety? Depression? Mood stabilising medication?
Cognition – affected by Dementia type conditions?
Behaviour – agitated? aggressive?
Drug Therapies and Medication – daily medication? PRN? Oxygen therapies?
Altered States of Consciousness – Seizure activity? Hallucinations? Absences or stroke?
The Checklist will go through the Applicant’s ‘medical needs’ in each domain. The checklist will be scored from A – B (with A being the highest and C being the lowest). The National Framework for Continuing Healthcare and Funded Nursing Care page 29 paragraph 85 states ‘The checklist threshold at this stage of the process has intentionally been set low, in order to ensure that all those who require a full assessment of eligibility have this opportunity….’
This means that everyone is entitled to a Continuing Healthcare Checklist and that the threshold to pass the Checklist and move on to the Decision Support Tool is pretty low. You need to score either:
2 or more Domains with a score of A
5 or more Domains with a score of B
1 priority Domain with a score of A
Once your Checklist is completed, the Applicant or their representative will be told if you have cleared the bar for a full assessment – this is often referred to as having ‘Checked In’ for a full assessment (Decision Support Tool). Your completed Checklist will be sent to your Local NHS Clinical Commissioning Group, and they will arrange your Decision Support Tool assessment for the Applicant. This should happen no later than 28 days after your Checklist.
If you do not ‘Check In’, The National Framework for Continuing Health Care and NHS Funded Nursing Care page 39 states:
‘101. A negative Checklist means the individual does not require a full assessment of eligibility and they are not eligible for NHS Continuing Healthcare.
102. If an individual has been screened out following completion of the Checklist, they may ask the CCG to reconsider the Checklist outcome. The CCG should give this request due consideration, taking account of all the information available, and/or including additional information from the individual or carer, though there is no obligation for the CCG to undertake a further Checklist.
103. A clear and written response should be given including the individual’s (and, where appropriate, their representative’s) rights under the NHS complaints procedure if they remain dissatisfied with the position.’
This means if you don’t ‘check in’ you can be reassessed after 3 months.
If you ‘check in’ – you will undergo a Decision Support Tool assessment.