Not many people know that they can avoid delays and shortcut the standard NHS Continuing Healthcare Funding (CHC) assessment process by applying for immediate NHS funding using the Fast Track Process.
Blog updated 23/03/23: Information fact checked. Links to National Framework updated. Links to supporting articles updated.
Fast Track funding is available if your relative meets the eligibility criteria i.e., has “a primary health need arising from a rapidly deteriorating condition and where that condition may be entering a terminal phase.” In that scenario, a fully-funded package of NHS care should be put in place within 48 hours of assessment to meet all their healthcare needs.
However, many families are not even aware that Fast Track funding even exists! This is hardly surprising, as little is overtly publicised by the NHS about its availability. Indeed, many medical professionals we speak to, including GPs, have no real knowledge or understanding of what CHC is, or even how the assessment process works. Yet, they are seeing patients on a daily basis – some of whom may, indisputably, be eligible for Fast Track funding and could missing out on free-funded NHS care at a time when it is most critically needed.
How does the Fast Track assessment process work?
Paragraphs 241 to 269 of the revised National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (July 2022) provide helpful guidance and support regarding Fast Track assessments.
A Fast Track assessment is carried out using the Fast Track Pathway Tool (revised July 2022) designed to anticipate future needs.
The Fast Track Pathway Tool is an abbreviated form, which records the individual’s condition (assessment, diagnosis & prognosis), their immediate and future needs and details of any deterioration (present and anticipated) with timescales.
The Fast Track Pathway Tool can be used in any care setting. So your relative doesn’t have to be in a care home.
Who can carry out the Fast Track assessment?
The Fast Track Pathway Tool will be completed by an ‘appropriate clinician’ to determine whether your relative has a ‘Primary Health Need’. The clinician should be someone who is responsible or knowledgeable about your relative’s health needs, their diagnosis, treatment or care. As such, they are best placed to provide an assessment of their health needs, and can comment on whether they have a rapidly deteriorating condition and may be entering a terminal phase.
An ‘appropriate clinician’ can be a registered nurse or registered medical practitioner, and is usually a Consultant, Registrar or GP. So, these are the people you urgently need to contact and request they complete the Fast Track Pathway Tool. Their clear reasons as to why your relative has a rapidly deteriorating condition and which may be entering a terminal phase, with supporting evidence, should be sufficient to trigger Fast Track Funding without delay. Speed is of the essence!
There are obvious advantages of using the Fast Track Pathway:
- A decision as to eligibility can be reached quickly and by a clinician who actually knows your relative’s needs; who is actively involved in their care; and has first-hand knowledge and experience of their rapidly deteriorating condition.
- It bypasses and replaces the usual lengthier full assessment process; dispenses with both the need to complete an initial Checklist; avoids delays whilst waiting for a full assessment by a Multi-Disciplinary Team and for their outcome to be communicated and then the package of care to be implemented.
What happens next?
The completed Fast Track Pathway Tool is submitted to NHS Integrated Care Board (ICB) together with a care plan (or as soon as available afterwards) in order for the ICB to support the care package.
Once approved, the ICB should communicate the outcome within 48 hours and a care package put in place immediately to meet your relative’s needs, wherever they choose to reside– with obvious beneficial financial and savings in funding care from private means. There should be minimal delay – hence ‘fast track’.
Remember: Even if your relative is already receiving a funded care package (but not through the NHS), it is still worth pushing for a Fast Track Pathway assessment to ascertain whether the NHS should take over funding of the care in full, at this stage.
Make sure you monitor the situation to ensure that the ICB actions the fast track care package promptly!
Common Fast Track Issues to watch out for:
- Your relative doesn’t have to be in a care home to access Fast Track Funding. The setting where care is provided is their entirely their choice. The main priority is to get the funding in place immediately.
- It is often wrongly assumed that you have to be at “death’s door” to seek a Fast Track assessment for CHC Funding. That is incorrect! A rapidly deteriorating condition can of course happen at any stage in life – and not just at a terminal phase.
- Expected length of life remaining is not a consideration that should be taken into account.
- The Integrated Care Board (ICB) cannot not make excuses that Fast Track Funding is too expensive. The cost of care is irrelevant and should not be a consideration.
- Although the Fast Track Pathway is usually seen as an end-of-life tool to assess people in their latter stages of life – that is not necessarily the case. The Fast Track Pathway Tool for NHS Continuing Healthcare (July 2022) can be used for individuals “who need access to NHS Continuing Healthcare quickly, with minimum delay…”
- Indeed, just because your relative may not be showing visible signs of significant clinical symptoms now, the nature of their condition and expected inevitable rapid deterioration in the future (progressing to a terminal phase) can, in itself, justify Fast Tracking. So, early planning for the inevitable and putting a contingency plan in place to meet the anticipated needs once they materialise, may help avoid unnecessary or repeat assessments in the future.
- You cannot use the Fast Track process to circumvent (‘cheat’) the CHC system. The Fast Track Pathway has to be used for genuine purposes. So, unless your relative meets the eligibility criteria i.e., has a rapidly deteriorating condition that may be entering a terminal phase, the Fast Track Pathway is not applicable. Instead, the ordinary Checklist assessment process should be used.
- Where your relative already has a care package in place that is not provided by the NHS, e.g,, it is funded by their local authority, a Fast Track Pathway assessment may still be required as Fast Track funding should be the responsibility of the NHS.
The ICB will usually undertake a review of the awarded Fast Track care package after 3 months to check that it is still needed and effectively meeting the individual’s needs. The NHS National Framework stipulates that those with a short life expectancy, should be funded until the end of their life.
If it is apparent that the original decision to award Fast Track funding is still appropriate, then the ICB may take the view that a review is unnecessary and continue to provide the existing CHC funded package.
Some reviews may inadvertently slip through the net and individuals may remain CHC funding indefinitely until the ICB realise their error or until the family applies for review as the current package of care is now inadequate to meet their relative’s increasing and more challenging needs.
Beware! Fast Track Funding should not be removed arbitrarily, i.e., without first undertaking a full review of the individual’s eligibility for CHC by a Multi-Disciplinary Team (MDT).
Of course, the worry of having a review pending can cause huge anxiety, as there is always the risk that it could trigger an MDT where it is decided that CHC Funding should be withdrawn.
Request a Fast Track Pathway assessment without delay if you believe your relative is eligible for Fast Track funding.
Critically, some individuals with a rapidly deteriorating condition, could mistakenly be shunted down the longer full assessment route, and miss out on vital CHC Funding, at a crucial time when it is needed most!