Fast Track CHC

Has anyone successfully applied for fast track CHC? I asked my Dad’s doctor if he would support and submit a fast track for my dad due to his deteriorating condition, he agreed but now he’s handed it over to the district nurse to do and she is arguing it’s only for people with a few days to live. I didn’t think it was meant to be based on anticipated end of life.

My Dad is palliative but I don’t know how long he will be with us. I just know that he needs nursing care as he’s quickly deteriorating mentally with dementia and he can no longer stand so is bed-bound. His care needs are more than I can provide adequately at home. He’s shouting all hours of the day and night and trying to get up because he thinks there are people in the house. He can barely feed himself as his coordination is off.

HI Elizabeth,
I suspect the district nurse doesn’t want the hassle. It isn’t up to her to decide if your Dad is eligible or not, there is an assessment process.

There are however changes to how CHC is dealt with at the moment due to the pandemic. Take a look here Changes to NHS Continuing Healthcare | COVID-19 Legislation - Beacon


CHC is for anyone young or old whose care needs are health related not social care related.

And its NOT just for end of life.

A man up the road very ill and disabled, he’s been on CHC for about 8 years now, he is ill but not at end of life just needs a lot of nursing care.

The District nurse is completely wrong and needs to be reported and struck off.

Bowlingbun is the expert at this, hopefully will be on to advice later.

The district nurse should be arranging extra support as well have you got a community care team in your area?, they provide extra support to anyone ill/disabled etc living at home.

FAST TRACK is the responsibility of the GP and should be arranged within 48 hours.

Have a look at the NHS Continuing Healthcare “Framework” and you will find a checklist assessment. Read the Framework and if you think dad qualifies for Fast Track, ring the Practice Manager with the relevant Framework pages in front of you, and give him the page number, section etc. If you don’t get any joy, go to the CCCG Complaints Officer.

Thank you so much for the advice, I’m definitely going to pursue CHC and will look at fast track in more detail. It feels like a lot of the medical professionals don’t understand the process themselves. I have a physio coming tomorrow to assess Dad’s lack of mobility so a report from her will definitely help.

Yes, I agree, if only the doctors had the system explained to them properly it would be so much better.

A few developments…

There was a lot of delay and confusion caused by my Dad’s GPs. The first doctor I spoke to at the beginning of August said he would support the Fast Track but after two weeks waiting I recontacted the doctors surgery to find out he had forgotten to do it! He’d increased my Dad’s dementia medication as requested but not submitted the Fast Track. Another GP said he would do it, I then got a phone call from Adult Social Care saying that they had received a request that I needed respite for Dad…again not what I wanted. We already have a 6 week joint funded respite package, that we haven’t used due to COVID and because I felt sending Dad away for a week and then bringing him home again would only worsen his confusion and dementia. What he desperately needs is permanent nursing home care.

The District Nurses are saying they’ve never known a GP submit a Fast Track and it’s always down to them to do it. The lady who deals with Fast Track requests for the nurses wants us to get Dad an allocated social worker so I’m waiting for that to happen (by end of this week apparently, despite my Dad’s case being marked as urgent.)

Dad was seen by the physio a few days ago who has decided he should be fully bed-ridden now and no longer stand up for pad changes etc as his legs are too weak from muscle wastage and his oxygen is dropping very low even when he just sits up on the bed. However, as his dementia is rapidly getting worse, he keeps trying to get up and is collapsing. We found him on the floor again on Saturday. We’re desperate now to get a Fast Track sorted, quite a few times I’ve been told it’s only for those who are end of life (ie days to live) and I’ve had to tell them that is NOT what it says on the Fast Track toolkit.

I haven’t had one explanation as to why Dad doesn’t qualify for a Fast Track, so I’m going to pursue it once his social worker is in place and if not that then at least a review of Continuing Health Care…although that might be difficult due to the COVID situation.

A last resort is self-funding and potentially losing the house that we all live in…difficult times.

Contact the CCCG Complaints Officer immediately. If the GP agreed 2 weeks ago, it should be sorted by now, especially as he already had a joint funded package. CHC can be provided either in a care home or the patients own home. Google Poynton Case Continuing Healthcare for more info.

On the subject of the house, you have been misinformed.

Thank you, it’s such hard work and a constant battle against misinformation and misdirection from the professionals we are supposed to put our faith in to help us. I don’t think the GPs understand what a Fast Track is. If I have no success with the social worker tomorrow I’m going to go back to the GPs and ask that they complete the Fast Track themselves.

I spoke to a finance assessor at the local council who has said providing we can prove we have lived in the house for 4 years they should give the house a discretionary disregard. I do hope that would be the case if we resort to having to have a finance assessment.

Complain to the CCCG Complaints Officer immediately.
Don’t wait for the social worker, if she was doing her job properly she’d have sorted this out already!

The CCCG is responsible for the GP and the CHC process, so let them sort it out between them, you have enough to contend with.
Look at the CHC Framework and read the relevant pages.

Maybe even send the details of the relevant pages to the Practice Manager, who should be ensuring they are following the rules properly, but again do not always know what the rules are.

Can I ask who is living in the house, and their ages?

It’s my Dad’s house, there are 5 of us living there including Dad.

I’m 41, my partner is 36 and we have two children aged 13 and 6.

I know that there are special rules when children are involved.
For full accurate details you need to Google “Charging for Care”. I think it’s on the .gov site.

I don’t know how long he will be with us. I just know that he needs nursing care as he’s quickly deteriorating mentally with dementia and he can no longer stand so is bed-bound. His care needs are more than I can provide adequately at home

Evadoll, ring Social Services immediately and say you CANNOT care for him any more.
You will need to be very forceful, asking nicely doesn’t work any more, sadly.
No need to shout or swear though, just say you cannot do it any more.
Social Services can arrange emergency care at home, emergency respite care, or the doctor can send him to hospital.
Think about packing an overnight bag in the mean time.
You have done enough, once someone is bed bound, especially with dementia, they need a round the clock team of carers, not just one worn out carer. Don’t feel guilty, dementia is a horrible disease.