Understanding NHS Continuing Healthcare Fast Track Funding - A Comprehensive Guide
For individuals with serious health conditions requiring urgent care at the end of their lives, the NHS Continuing Healthcare Fast Track pathway can provide essential funding.
But what exactly is it? How do you get it? How long does it last? And what pitfalls should you watch out for? Many families find the process confusing, but understanding your rights can make all the difference.
This article explains everything you need to know about CHC Fast Track funding to help you navigate the system effectively, and in simple terms, so you know what to expect and how to ensure your relative gets the care they need.
What is NHS Continuing Healthcare (CHC) Fast Track Funding?
NHS Continuing Healthcare [CHC] is a package of care, fully funded by the NHS, for individuals with significant ongoing healthcare needs. The Fast Track Pathway is a specific process designed for those with “a rapidly deteriorating condition that may be entering a terminal phase.” i.e. entering the final stages of life.
Fast Track funding is designed to replace the lengthier standard CHC assessment process and get a quick decision of eligibility for CHC, so that urgent package of appropriate care can be put in place immediately, without unnecessary delays. It is particularly beneficial for those who are considered End-of-Life and require immediate care – regardless of whether in their own home, a care home, hospice or other care facility.
Sadly, many families are not even aware that Fast Track funding exists, and the same can equally apply to private or NHS clinicians and consultants alike. So, it may not be on their radar to even mention it unless you ask! So, if your relative has a rapidly deteriorating condition that may be entering a terminal phase, you should always check whether they qualify for Fast Track.
Who is Eligible for CHC Fast Track Funding?
To qualify for CHC Fast Track funding, an individual must:
- Have a rapidly deteriorating condition
- Have urgent, intensive and ongoing healthcare needs
- Be nearing the end of life
Who carries out the Fast Track Assessment?
An ‘appropriate clinician’ such as a registered medical practitioner (eg GP) or registered nurse, must complete a Fast Track Pathway Tool to confirm eligibility.
Unlike standard CHC applications which involves a Multi-Disciplinary Team meeting and decision-making panel, this is a quick, clinician-led process, with no need for a full assessment or lengthy wait for a panel decision. The intention is to avoid unnecessary delays or gaps in the provision of care.
If Fast Track is recommended, then the local NHS Integrated Care Board [ICB] should implement that recommendation within 48-hours.
How Do You Get CHC Fast Track Funding?
Referral by a Clinician:
- A doctor, registered nurse, or other healthcare professional must complete the Fast Track Pathway Tool, confirming the urgent need for care. This can often be done by a patient’s treating Consultant whilst in hospital. This form is then submitted to the local ICB responsible for CHC funding.
- The Fast Track Pathway Tool can also be completed after a Checklist, if it becomes apparent at that point that the Fast Track criteria are met.
Approval Process:
- CHC Fast Track funding is approved swiftly, within 48 hours (maximum) from receipt of the Fast Track Pathway Tool, to ensure that care is put in place immediately.
- Once approved, a care package should be put in place without delay and can be provided in any setting, depending on the individual’s needs and preferences.
Implementation of Care:
- The NHS will arrange and fully fund a care package that meets the individual’s needs which may include specialist equipment, nursing, palliative care, and support from carers.
How Long Does CHC Fast Track Funding Last?
Fast Track funding is not intended to be permanent. The initial care package is approved on an urgent basis, but ongoing eligibility is subject to review:
Regular Reviews:
- The NHS typically reviews Fast Track funding after a few weeks (usually within 3 months) to determine whether the individual still meets the criteria.
- If the condition stabilises or improves, the NHS may reassess eligibility and refer the individual to the standard CHC assessment process (or social care services).
Potential Continuation:
- If the individual’s condition continues to deteriorate and the original eligibility decision was appropriate, CHC funding may remain in place without the need for reassessment.
- The NHS National Framework also provides that where an individual is receiving services from use of the Fast Track Pathway Tool is expected to die in the very near future, the ICB should continue to take responsibility for the care package until the end of their life.
Withdrawal of Funding:
- If an individual’s condition improves significantly or they no longer qualify, they may be moved off CHC Fast Track funding and into another form of care, which could involve financial contributions from the patient or their family.
- However, Fast Track funding should not be removed without the individual’s eligibility being reconsidered through the completion of a Decision Support Tool by a Multi-Disciplinary Team to determine eligibility for NHS Continuing Healthcare.
- Care Home and ICBs may not warn patients or their families, that if CHC funding is withdrawn, they may be left to cover care costs themselves! This unexpected shock can come as a real financial blow to some families who have placed their relative into an expensive care home, believing that Fast Track funding would continue indefinitely, or were not expecting their relative to survive beyond 3 months. So, always prepare for this financial possibility.
Common Pitfalls and Challenges to Watch Out For
While CHC Fast Track funding can be a lifeline for individuals needing urgent care, here are potential pitfalls to be aware of:
Delays in Processing:
Although Fast Track funding should be approved within 48 hours, administrative delays can sometimes occur. If there are delays, families must follow up with their local ICB and insist on prompt action.
Refusal to consider Fast Track
The National Framework for NHS Continuing Healthcare Funding does not include any process for disputing an ICB’s refusal to even consider a Fast Track assessment and/or their refusal to award Fast Track funding. You can, of course, complain, but that all takes time, whilst your relative may be in rapid decline at End-of-Life. The alternative is to request a full assessment and trigger the lengthier standard CHC process, but that might be impractical if the individual is going to pass away imminently.
Withdrawal of Funding After Review:
One of the biggest challenges families face is the sudden withdrawal of funding after an initial review leading to unexpected costs. This can cause financial distress, especially if the family are not told that Fast Track funding is only intended to be a temporary measure, and then have to use private savings or resources to meet the daily costs, or even have to sell their own home to pay for ongoing care.
Families should prepare for this possibility by discussing alternative funding options in advance.
Lack of Awareness Among Healthcare Professionals:
Finding a professional to carry out the Fast Track Assessment, and to do it promptly, can often be challenging in itself leading to delays in referrals! Many GPs we have spoken to have little awareness of CHC funding, let alone even heard of the Fast Track, or have the time to attend to this urgently.
Variation in Decisions Across Regions:
The application of Fast Track criteria can vary between different local ICBs, leading to inconsistencies in decision-making. Some NHS areas apply Fast Track criteria more strictly than others. If funding is refused, challenge the decision and ask for an explanation in writing.
What to Do if Fast Track Funding is Withdrawn
If an individual’s Fast Track funding is withdrawn after review, there are steps families can take:
- Request a Review:
If you disagree with the decision, you can raise a complaint, but as Fast Track Funding is at the discretion of the ICB, this is unlikely to be upheld in your favour; and complaints take time!
- Apply for Standard CHC Funding:
If the individual still has significant ongoing healthcare needs, they may qualify for regular CHC funding through a full assessment, starting with a Checklist assessment. See our helpful blogs below.
- Explore Alternative Funding Options:
If CHC is not available, social care funding may be an option, although it is means-tested, so you may have to contribute to some or all of your care. Charities and local support organisations may also provide financial assistance.
- Seek Legal or Advocacy Support:
Organisations such as Farley Dwek Solicitors, specialists in NHS CHC Funding, can provide advice and support in challenging funding decisions.
Final Thoughts…
NHS Continuing Healthcare Fast Track funding is designed to provide urgent care for those with rapidly deteriorating health conditions nearing End-of-Life. The process is intended to be straightforward and quick. By understanding the system and advocating for your relative, families can ensure that they receive the care they need without delay and avoid unnecessary financial burden.
Families must be proactive and push for this Fast Track assessment, where there is an appropriate and genuine need.
Knowing your rights can make all the difference in securing the care your relative needs. Stay informed, ask questions, and fight for the support they deserve.
For more background reading on the subject, take a look at these helpful blogs:
Understanding The Checklist Assessment
Getting started with CHC? How does the CHECKLIST work?
Understanding the Multidisciplinary Team Meeting
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