CHC Domains (Areas of Need)

1. Behaviour
2. Cognition
3. Psychological and emotional needs
4. Communication
5. Mobility
6. Nutrition (food and drink)
7. Continence
8. Skin, including tissue viability
9. Breathing
10. Drug therapies and medication (symptom control)
11. Altered states of consciousness
12. Other significant care needs that need to be taken into consideration.

There are three checklist descriptions:

• No or low needs
• Moderate needs
• High needs

A full assessment is required if the checklist shows:

• Two or more domains are rated as high
• Five or more domains are rated as moderate
• One domain rated as high and four as moderate
• A high rating in any of the domains with a priority level (in the DST) plus any level of need in the other domains (see column on the left).

There are six assessment descriptions: 
1.    = no needs
2.    = low needs
3.    = moderate needs
4.    = high needs
5.    = severe needs *
6.    = priority needs*

*does not apply to some of the care domains.

The assessment team should also use the four key characteristics of need (nature, intensity, complexity and unpredictability) wherever relevant.

Each of the four key indicators may alone, or in combination, indicate a primary health need.

The team should use their professional judgement to consider the totality of need identified across the domains and indicators. 

A recommendation  of eligibility would be expected if the patient has: 

A priority level of need in any of the four domains where it is possible to have a priority need; or

Two or more instances of sever needs across all domains. 

A primary health need may also be indicated if: 

There is one domain recorded as severe together with needs in a number of other domains where it is possible to have a priority need; or

A number of domains with high/moderate needs. 
In these cases, the combination of needs is taken into account in assessing whether someone has a primary health need.