The CHC Checklist: how the screening stage works

How the scoring works

A health or social care professional scores 11 care domains as A (high), B (moderate), C (low or no need). In England you should be referred for a full assessment if there are two or more A scores, five or more B scores, one A plus four Bs, or a single A in a domain marked with an asterisk (behaviour, breathing, drug therapies, altered states of consciousness).

Wales uses its own screening documentation under the Continuing NHS Healthcare National Framework for Wales. The purpose is the same — a low-threshold filter into full assessment — so if the recorded needs are anywhere near the threshold, ask for the full assessment.

What should happen

You should be told a Checklist is being completed, consent should be sought from the person (or best-interests process followed where they lack capacity), and you should be given a copy of the completed Checklist with the outcome and reasons in writing.

• Ask for the Checklist to be completed if nobody has offered one
• Ask for a copy, including the reasoning behind each domain score
• Ask who completed it and what evidence they used

How to prepare

The single most useful thing you can bring is a factual record of a typical week — not a good day. Include night-time needs, refusals, incidents, how long tasks take, and how often plans have to change because of the person's health.

• A 7 to 14 day diary covering days and nights
• Recent hospital letters, GP notes, medication changes
• Care home or care agency daily notes and incident logs
• A short list of what has deteriorated in the last 6 months

If the Checklist is negative

A negative Checklist can be challenged. Ask the ICB (England) or Local Health Board (Wales) in writing to review the screening decision, explain which domains you believe were under-scored and why, and attach your evidence. If needs have changed since, you can also request a fresh Checklist.