Fast Track Continuing Healthcare

In two previous blogs the National Health Service (NHS) Continuing Healthcare (CHC) was discussed, as well as NHS care fee disputes. To obtain the CHC funding, there is something called Fast Track CHC, which is an acceleration CHC process that allows the person who is approaching the end of his/her life to receive fully funded care as soon as possible. The process skips the CHC Checklist and the Multi-disciplinary Team steps and is replaced with an appropriate clinician completing the Fast Track Pathway Tool (FTPT) (see Fast-track pathway tool for NHS continuing healthcare guidance – GOV.UK) documenting the nature of the person’s condition and evidence that needs are rapidly increasing. The FTPT is submitted to the Integrated Care Board (ICB) and funding and the appropriate care package must be put in place in no more than 48 hours.

Who completes the FTPT?

As mentioned above, an appropriate clinician should complete the FTPT and that refers to a consultant, general practitioner, registered nurse or another healthcare professional, who is knowledgeable about the person’s health needs, diagnosis, treatment or care. The ICB generally does not question the recommendation except in cases of evidenced error or lack of eligibility.

Who is eligible for the Fast Track CHC?

As mentioned above, the person has to be approaching the end of life and have a rapidly deteriorating condition. ‘End of life’ is not legally/medically and strictly defined, it covers those likely to be in the terminal phase of illness or anticipated to be in the last weeks or days of life.

The completion of the FTPT itself is sufficient to demonstrate eligibility, but a prognosis (if available) and a care plan will be required that describes the immediate needs to be met and the person’s preferences.

It is possible that the person may present only a few symptoms but it is clear that rapid deterioration is to be expected in the near future. In this case, in order to avoid the need for unnecessary or repeat assessments, it may still be appropriate to use the Fast Track CHC.

What to do if the decision is negative?

The person and/or his/her family should first obtain written reasons for the negative decision before preparing a complaint to the ICB. In the complaint, a request for the decision to be reviewed by a senior clinician (ideally one with specialist end-of-life care expertise) can be made.

What to do if there is a delay in funding?

The funding should take effect from the point at which it should have been put in place. If care and costs have been privately arranged pending funding, the person and/or his/her family should seek reimbursement supported by documentation/receipts.

Will the Fast Track CHC last until the person dies?

Not necessarily. It does not usually have a fixed time limit, but the ICB typically reviews the case within the first 3 months of implementation to ensure the criteria are met. If the person’s condition improves or stabilises, the ICB may decide to withdraw funding and recommend a full CHC assessment instead.