At Hugh James, we understand that witnessing a deterioration in your relative’s health is distressing. We also recognise that, at times, you are not provided with clear guidance as to what funding options are available to assist you at this difficult time in relation to your relative’s future care.
In this blog, we provide you with information surrounding the fast track assessment process and whether such an assessment should be completed.
According to recent data from NHS England, the total number of people eligible for NHS Continuing Healthcare on the last day of Q3 2018-19 was 54,754, with 18,151 of these eligible for fast track Continuing Healthcare.
The main purpose of the fast track tool is to ensure that an individual who has a rapidly deteriorating condition or is entering a terminal phase of an illness is assessed for Continuing Healthcare funding with “minimum delay” without the requirement to complete a Decision Support Tool (DST).
If it is found that a person is entering the terminal phase of an illness, or has a rapidly deteriorating condition, they will be found eligible for full NHS Continuing Healthcare Funding under the fast track criteria.
The fast track tool can be completed in any setting including in the individual’s home, should they wish to remain there.
The fast track tool must be completed by an “appropriate clinician” who will complete the tool providing clear reasons to support their decision. The appropriate clinician is someone who is knowledgeable about the individual’s diagnosis and treatment. The appropriate clinician is:
- The person responsible for the diagnosis, treatment or care of the individual under the National Health Services Act 2006; and
- A registered nurse or registered medical practitioner.
A clinician employed in independent sector organisations which have a specialist role in end of life care, for example hospices, can refer an individual to an appropriate clinician should they consider that an individual meets the fast track criteria.
The guidance regarding fast track assessments indicates that ‘rapidly deteriorating condition’ should not be interpreted narrowly. However, there is no confirmed definition as to what is required to demonstrate a rapidly deteriorating condition.
It is also confirmed that the ‘terminal phase’ is not restricted to situations where death is imminent.
If a recommendation is made for funding under the fast track pathway tool, the Clinical Commissioning Group should accept and action this request immediately.
Sadly, as with a full assessment for NHS Continuing Healthcare funding, the agreement for fast track funding is not indefinite. An individual’s condition is subject to review and in the event that it is determined that an individual no longer meets the criteria for fast track funding, eligibility can be removed. However, if it is apparent that an individual is nearing the end of their life and the original decision regarding eligibility was appropriate, a review of the decision is unlikely to be required.
If it is believed that a person no longer qualifies for fast track funding, their needs must be reviewed by way of a full DST.
If it is clear that your relative is deteriorating rapidly or is entering the terminal stage of an illness, we recommend that you speak an appropriate clinician, as referred to above.