NHS Fast Track Funding: How Fast Track CHC Works in England
If someone’s health is deteriorating rapidly and they may be entering the final phase of their life, NHS Continuing Healthcare may be available through the Fast Track pathway.
Unlike ordinary social care funding, Fast Track CHC is not means-tested. The decision is based on the person’s health and care needs, and an appropriate clinician completes the Fast Track Pathway Tool.
Could Fast Track funding apply?
If your loved one is deteriorating quickly and may be entering a terminal phase, ask the healthcare professional involved in their care whether they should be considered for the NHS Continuing Healthcare Fast Track pathway.
Don’t wait for a financial assessment. Fast Track is an NHS healthcare funding route, not a means-tested social care benefit.
What is NHS Fast Track funding?
NHS Continuing Healthcare (CHC) is care arranged and funded entirely by the NHS for adults who meet the eligibility requirements. Most people who are considered for CHC go through a standard assessment process.
The Fast Track pathway is different. It is designed for people with a rapidly deteriorating condition who may be entering a terminal phase and who need an appropriate care and support package put in place quickly.
Instead of going through the normal CHC Checklist and Decision Support Tool process, an appropriate clinician completes the NHS CHC Fast Track Pathway Tool and sends it to the relevant Integrated Care Board (ICB).
Who is Fast Track funding for?
The Fast Track pathway is intended for someone whose condition is rapidly deteriorating and may be entering a terminal phase.
That does not mean there is one particular diagnosis that automatically qualifies someone. The focus is on the person’s clinical situation, deterioration and need for urgent care.
Someone may be receiving care:
- at home
- in a care home
- in a nursing home
- in hospital
- or in another appropriate care setting
The Fast Track pathway can be particularly important when a person’s condition has changed quickly and the family needs an appropriate package of care arranged without waiting for the standard CHC assessment route.
Does Fast Track depend on savings or owning a house?
No.
NHS Continuing Healthcare is fundamentally different from local-authority social care funding. CHC is based on assessed health and care needs rather than a financial means test.
That means families should not assume that someone has to spend their savings, sell their home or reach the council’s care-funding thresholds before asking whether NHS funding may apply.
This is particularly important if a family is currently trying to work out whether they will have to pay for a care home themselves.
If you are trying to understand the wider funding picture, our guide to the true cost of a care home explains how self-funding, local-authority funding, NHS-funded nursing care and CHC fit together.
Who completes the Fast Track Pathway Tool?
The Fast Track Tool is not something a family completes themselves.
It is completed by an appropriate clinician who is responsible for the person’s diagnosis, treatment or care and who has appropriate knowledge and experience of the person’s health needs.
This can include an appropriately qualified doctor or registered nurse.
The clinician should provide the reasons why they consider the Fast Track criteria to be met and send the completed tool to the relevant ICB.
What should you actually say?
You don’t need to become an expert in CHC terminology.
You can simply ask:
“Their health is deteriorating rapidly and we are concerned they may be entering the terminal phase. Could you consider whether the NHS Continuing Healthcare Fast Track pathway is appropriate?”
How quickly can Fast Track funding be arranged?
The purpose of Fast Track is to avoid unnecessary delay when someone needs an urgent care package.
NHS guidance says that where someone meets the Fast Track criteria, an appropriate care and support package should be put in place as soon as possible, usually within 48 hours.
This is one of the most important differences between Fast Track and the ordinary CHC route.
The person’s condition is rapidly deteriorating and may be entering a terminal phase.
An appropriate clinician considers whether the Fast Track pathway is appropriate.
The clinician completes the NHS CHC Fast Track Pathway Tool and sends it to the ICB.
The NHS works to put an appropriate package of care in place urgently.
Where can Fast Track care be provided?
Fast Track CHC is not limited to nursing homes.
Depending on the person’s needs and the options available locally, care may be arranged in a range of settings, including:
- the person’s own home
- a nursing home
- a residential care home
- a hospice or other appropriate setting
The person’s preferences should be part of the conversation about how and where their care is provided.
If a care home is being considered, our care needs and care-home assessment can help you think about the type of setting that may be appropriate.
What does Fast Track actually pay for?
If someone is eligible for NHS Continuing Healthcare through Fast Track, the NHS arranges and funds the assessed package of care.
The exact package depends on the person’s needs and circumstances. It is therefore not appropriate to describe Fast Track as a fixed weekly payment or a standard contribution towards a care-home bill.
This is different from NHS-funded nursing care (FNC), which is a nationally set weekly payment made by the NHS to an eligible nursing home for the nursing care it provides.
Fast Track CHC
- For rapidly deteriorating conditions that may be entering a terminal phase
- Clinician-led
- Not means-tested
- Urgent NHS CHC funding route
- Package based on assessed needs
NHS-funded nursing care
- For eligible people receiving nursing care in a nursing home
- Separate from CHC
- Fixed national weekly rate
- Does not normally pay the whole care-home fee
For more information, read our complete guide to NHS Continuing Healthcare.
What if the person stabilises?
Fast Track funding is based on the person’s clinical circumstances at the time the pathway is used.
If their condition stabilises, the NHS may review whether Fast Track remains appropriate. Depending on the outcome, they may continue to receive NHS Continuing Healthcare, move to another funding arrangement, or no longer meet the criteria for NHS CHC.
This means families should not assume that Fast Track funding will necessarily continue unchanged indefinitely.
If the funding decision changes, the family should be given information about what happens next and what other care and funding options are available.
Fast Track versus the normal CHC assessment
It is useful to understand that Fast Track is not simply a faster version of the normal Checklist.
Standard CHC route
- Initial CHC Checklist
- Full assessment where appropriate
- Decision Support Tool (DST)
- Multidisciplinary team recommendation
- ICB decision
Fast Track route
- Rapid deterioration identified
- Appropriate clinician considers Fast Track
- Fast Track Pathway Tool completed
- Tool sent to the ICB
- Urgent care package arranged
If your relative is not in a rapidly deteriorating situation but you believe their overall health needs may amount to a primary health need, our NHS Continuing Healthcare guide explains the standard process.
What if Fast Track isn’t appropriate?
Fast Track isn’t the only route to NHS funding.
If your relative’s condition is not rapidly deteriorating or the Fast Track pathway isn’t considered appropriate, you can still ask whether they should be considered for standard NHS Continuing Healthcare.
If they are receiving nursing care but don’t qualify for CHC, they may instead be eligible for NHS-funded nursing care.
And if NHS funding isn’t available, the local authority may still have responsibilities for assessing care needs and financial circumstances.
Don’t let the funding route become a guessing game
Our Care Funding Calculator can help you understand the likely social-care funding position based on savings, income, property and your local authority.
But remember: CHC and Fast Track are healthcare funding routes and are not determined by the social-care means test.
What should families do now?
Speak to the healthcare team
Ask the GP, consultant, registered nurse or other appropriate clinician involved in the person’s care whether Fast Track CHC should be considered.
Explain what has changed
Be clear about the deterioration, the risks, the level of care now required and why an urgent package may be needed.
Don’t focus on the financial assessment
Fast Track CHC is not means-tested. The person’s savings and property should not be the reason they are excluded from consideration.
Ask what happens next
Find out whether the Fast Track Tool has been completed, where it has been sent and who is coordinating the NHS response.
What evidence should you keep?
Although the Fast Track route is designed to be urgent, it is still useful for families to keep clear information about what is happening.
- Recent medical correspondence
- Changes in mobility or ability to transfer
- Changes in eating, drinking or swallowing
- Changes in medication or symptom management
- Changes in continence
- Episodes of distress, confusion or altered consciousness
- Increasing need for nursing or personal care
- Hospital admissions or significant clinical deterioration
- Information about what care is now required day and night
If the person later enters the standard CHC assessment process, understanding how evidence is considered becomes particularly important. Our Mock CHC Decision Support Tool can help families understand the twelve care domains used during the full assessment.
You can also download our free CHC assessment preparation checklist.
Not sure which funding route applies?
Care funding can be confusing, particularly when a person’s health is changing quickly. Start with the questions that matter most and work out which route you should explore.
Frequently asked questions
Does Fast Track CHC depend on savings?
No. NHS Continuing Healthcare is not means-tested. Fast Track eligibility is based on the person’s health and care circumstances, not their savings, income or property.
Does someone have to have cancer to qualify for Fast Track?
No particular diagnosis automatically qualifies someone. The Fast Track pathway is intended for people with a rapidly deteriorating condition who may be entering a terminal phase and need an urgent care package.
Can someone receive Fast Track funding at home?
Yes. NHS Continuing Healthcare can be provided in different settings, including someone’s own home and a care setting, depending on their assessed needs and the care package arranged.
Who completes the Fast Track Tool?
An appropriate clinician completes the NHS CHC Fast Track Pathway Tool. Families do not complete the clinical decision themselves.
How quickly can Fast Track funding start?
The Fast Track pathway is designed to enable an appropriate care and support package to be put in place as soon as possible, usually within 48 hours.
What happens if the person gets better?
The NHS may review the person’s eligibility and whether Fast Track remains appropriate if their condition stabilises. The funding arrangement can therefore change.
What if Fast Track isn’t appropriate?
You can still ask whether the person should be considered for standard NHS Continuing Healthcare. If they need nursing care but aren’t eligible for CHC, NHS-funded nursing care may also be relevant.
Important: This guide is for information and navigation only. It does not determine eligibility for NHS Continuing Healthcare or Fast Track funding. Fast Track eligibility is established through the NHS Fast Track Pathway Tool completed by an appropriate clinician, and the relevant Integrated Care Board makes the necessary arrangements.