Updated June 2026. The Decision Support Tool, often called the DST, is used during a full NHS Continuing Healthcare assessment. It helps the multidisciplinary team record and consider a person’s care needs across a set of care domains.

The DST can feel intimidating because it uses formal NHS language. For families, the most important thing to understand is that it is not meant to be a simple points test.

What does the DST cover?

The DST looks at areas such as behaviour, cognition, psychological and emotional needs, communication, mobility, nutrition, continence, skin, breathing, medication, altered states of consciousness and other significant needs.

Each area is considered in terms of the level and type of need. The team then looks at the overall picture, including the nature, intensity, complexity and unpredictability of the person’s needs.

Why is it not just a scorecard?

Families sometimes expect eligibility to be decided by adding up scores. The DST is more nuanced than that. The decision is about whether the overall care needs amount to a primary health need.

That means one person’s needs may look different from another’s even if they share the same diagnosis. The context, risks and day-to-day management of care all matter.

How does this connect to the Checklist?

The Checklist is usually the screening stage. The DST is used when a full assessment is needed. You can read our overview of the NHS Continuing Healthcare Checklist if you are at the beginning of the process.

What should families understand before an assessment?

It helps to know the purpose of the DST before attending a meeting or reading assessment paperwork. It is there to structure the discussion, not to replace the overall judgement about need.

For a fuller plain-English explanation of the process, see The Family Guide to NHS Continuing Healthcare Funding.

Process lesson

DST paperwork is usually strongest when it is organised by domains and current assessed needs. For readers, the key is to understand the structure before trying to interpret the result.

Quick FAQ

Is the DST a points test?

No. The DST records levels of need, but the final question is the overall primary health need.

Who uses the Decision Support Tool?

It is normally used by a multidisciplinary team during a full CHC assessment.

Official information

For formal NHS information, see the NHS page on NHS Continuing Healthcare and the GOV.UK collection on NHS Continuing Healthcare and NHS-funded nursing care.

General educational information only. Continuing Healthcare Guide does not provide consultancy, advocacy, appeals representation, legal advice, financial advice, medical advice or telephone support.