What is the CHC Decision Support Tool?

Navigating care options for a loved one can feel overwhelming, especially when their needs start to change. The CDC Decision Support Tool is designed to help families and professionals make informed choices about care funding and eligibility – offering clarity during what can be a confusing time.

Understanding how this tool supports decision-making around NHS Continuing Healthcare (CHC) funding can give you greater confidence and peace of mind when planning care. In this guide, we’ll explain what the CDC Decision Support Tool is, how it works and what to expect from the process.

Understanding NHS Continuing Healthcare (CHC)

NHS Continuing Healthcare (CHC) is a package of care arranged and fully funded by the NHS for individuals with significant and ongoing health needs. It’s designed to cover the full cost of care, whether at home, in a care home or another setting, for those whose primary need is a health need.

Eligibility for NHS CHC doesn’t depend on a specific diagnosis – it’s based on the nature and complexity of someone’s care needs. If a person’s health requirements go beyond what social care can provide, they may be assessed for NHS CHC funding.

You can learn more about how NHS Continuing Healthcare funding works and who may be eligible by speaking to a healthcare professional or visiting the NHS website for up-to-date guidance.

What is the CHC Decision Support Tool?

The CHC Decision Support Tool is a document used by health and social care professionals to help determine whether someone qualifies for NHS Continuing Healthcare funding. It brings together information from a full assessment of an individual’s care needs and helps guide the decision-making process in a fair and consistent way.

Rather than making the final decision, the tool supports recommendations by setting out how needs are scored across key areas – such as mobility, cognition, breathing, nutrition and more. This structured approach ensures that all relevant aspects of a person’s health and care needs are considered clearly and objectively.

Understanding how the CHC Decision Support Tool works can make the assessment process feel less daunting and help you feel more prepared when discussing care options.

When is the Decision Support Tool used?

The Decision Support Tool is used after an individual has had an initial screening with the CHC Checklist. If the checklist suggests that the person may be eligible for NHS Continuing Healthcare, a full assessment is arranged – and it’s during this assessment that the Decision Support Tool is completed.

This tool helps structure the assessment by setting out clear criteria and evidence-based scoring. It allows the professionals involved to build a detailed picture of someone’s care needs, supporting a recommendation on whether NHS CHC funding is appropriate.

What does the CHC Decision Support Tool assess?

The CHC Decision Support Tool looks at 12 specific areas of care – known as care domains – to understand the type and level of support an individual needs. Each domain is assessed and given a level of need, ranging from ‘no need’ to ‘priority.’

These care domains include:

Mobility – How easily someone can move around, including their need for assistance or equipment
Cognition – Issues related to memory, decision-making and understanding
Behaviour – Any challenging or risky behaviours that may require support
Nutrition – Support needed with eating, drinking or maintaining a healthy diet
Continence – Help required with managing bladder or bowel needs
Skin integrity – Including risks of pressure sores or need for wound care
Breathing – Any respiratory conditions or support such as oxygen therapy
Drug therapies and medication – Support with taking medication or managing side effects
Psychological and emotional needs – Support needed due to mental health or emotional well-being
Communication – How someone expresses themselves and understands others
Other significant needs – Such as palliative care or other complex health issues
Altered states of consciousness – Including seizures or sudden episodes of unconsciousness

Each of these domains helps build a complete picture of a person’s care needs, supporting a recommendation on whether they qualify for NHS Continuing Healthcare.

What does the scoring mean?

Each care domain within the CHC Decision Support Tool is given a score that reflects the level of need. These scores help the multidisciplinary team understand how serious and complex a person’s health needs are.

The levels of need are:

No needs – The person is fully independent in this area
Low – Some minor support is needed
Moderate – Regular help is required, but needs are generally predictable
High – Needs are intense and frequent, requiring skilled care
Severe – Needs are serious, possibly life-threatening and require constant supervision
Priority – The highest level of need, indicating critical care requirements

Generally, having a priority level in any one domain, or severe levels in multiple domains, can lead to approval for NHS Continuing Healthcare funding. However, the final decision also takes into account the overall interaction and intensity of all assessed needs.

How is eligibility decided?

Eligibility for NHS Continuing Healthcare is decided by a multidisciplinary team (MDT) following a full assessment using the Decision Support Tool. This team – typically made up of healthcare and social care professionals – carefully reviews the information gathered and scores each of the 12 care domains.

The team doesn’t just look at individual scores in isolation. They consider the overall picture of need, including how different needs interact with and impact one another. This holistic view helps determine whether the person’s primary need is a health need, which is key to qualifying for CHC funding.

The final decision is based on professional judgment, guided by the evidence collected and the scoring framework of the tool. If CHC funding is approved, the NHS becomes responsible for covering the full cost of care.

How can families prepare for a CHC assessment?

Preparing for a CHC assessment can help families feel more confident and involved in the process. While the assessment is led by healthcare professionals, there are several things you can do to ensure your loved one’s needs are fully understood.

Here are a few practical ways to get ready:

Understand the process – Familiarising yourself with how CHC assessments work, including the Decision Support Tool, can help you know what to expect
Gather medical evidence – Collect relevant documents such as hospital reports, care notes, medication lists and GP summaries to provide a full picture of health needs
Keep a care diary – Note down day-to-day challenges, behaviours and support provided – this can highlight needs that may not be obvious in a clinical setting
Involve a care provider – If your loved one is receiving home care, their care team can offer valuable input and supporting evidence
Ask questions – Don’t be afraid to speak up during the assessment and ask for clarification if anything is unclear

Taking these steps can help ensure the assessment reflects the reality of your loved one’s needs, making it more likely that they’ll receive the right level of support.

What if you’re not eligible for CHC funding?

If someone is assessed and doesn’t meet the criteria for NHS Continuing Healthcare, it’s natural to feel disappointed – but it’s important to know that this isn’t the end of the road. There are other funding options available, and you also have the right to appeal the decision.

Here’s what to consider:

Request a review – If you believe the assessment didn’t reflect your loved one’s full needs, you can request a review or appeal. This may involve providing additional evidence or asking for another assessment
Explore local authority funding – If CHC is not awarded, care may still be funded through your local authority. This support is means-tested and based on the individual’s income, savings and assets
Consider a joint package – In some cases, the NHS and local authority may work together to provide a joint package of care
Seek professional advice – If the process feels overwhelming, a care provider or independent adviser can help you understand your options and support you through any appeals

Even if CHC funding isn’t approved, support is still available. Understanding your next steps – and your rights – can help you feel more in control of the situation.

How home care supports CHC-funded clients

Trinity Homecare provides specialist support for individuals with complex health needs, whether funding is secured or still pending. Our dedicated team works closely with clients to ensure they receive the right level of care, tailored to their unique needs and preferences.

For CHC-funded clients, this means delivering care that aligns with the specific requirements outlined in their funding plan. Whether the care is focused on mobility support, medication management, or personal care, our highly trained staff are equipped to handle the complexities of these needs.

Even if CHC funding is still pending, Trinity Homecare can provide interim care, ensuring your loved one is supported while awaiting a decision. Our team will work with you to gather all necessary documentation, helping to make the assessment process as smooth as possible.

With the right home care in place, clients can remain in the comfort of their own homes, enjoying the benefits of personalised, expert care while navigating the funding process.

Talk to us today

At Trinity Homecare, our ultimate goal is to enrich your lifestyle in the comfort and familiarity of your own home. This allows you to live the independent lifestyle that you love without the daunting thought of moving into a care home.

Call us now on 0207 183 4884 in confidence for a free, no obligation quotation. If enquiring outside of our opening hours, please complete our online form and we will contact you the next day.