Discharge to Assess Pathway 3 (24-hour care + assessment)

Pathway 3 is for patients who are unlikely to recover the level of independence to return home. The NHS funds a 24-hour bed-based stay while the long-term plan is set.

The short answer. Pathway 3 places the patient in a 24-hour care or nursing home while a long-term decision is made. The NHS funds the assessment window, usually up to 6 weeks. At the end, the patient either stays under self-funding or council funding, or transfers to CHC if a Fast Track is signed.

When Pathway 3 applies

Substantial physical or cognitive decline making home unsafe.
Complex nursing needs (catheter, PEG feeding, advanced wound care).
Advanced dementia with risk behaviours.
Family unable to provide the level of care now required.

Is Pathway 3 always permanent care?

Not always. The point of the assessment window is to test. Some patients on Pathway 3 recover enough to return home with Pathway 1 support. Others move to permanent residential or nursing care. A few are Fast-Tracked to CHC if they deteriorate further.NHS England D2A ↗DHSC guidance ↗

Triggering CHC Fast Track during Pathway 3

Yes - it is a common route. If the patient deteriorates during the Pathway 3 stay, the GP, care home clinical lead or visiting palliative team can sign a Fast Track Pathway Tool. The NHS then assumes full funding from the date of approval.CHC Framework ↗

Who decides the long-term placement

The assessment team includes a social worker, a nurse, and often a member of the family. The decision must be in the patient's best interests. The family can challenge a decision via the council complaints route and the Local Government and Social Care Ombudsman.

Frequently asked

Does the family choose the long-term home?

You can express preferences. The council must pay the contract rate for a suitable home in the area. For a more expensive home a third-party top-up may be needed.

What if the patient improves and wants to go home?

If assessment supports a safe return home, the patient is discharged to Pathway 1 or 0 with appropriate support.

Can the NHS extend Pathway 3 beyond 6 weeks?

Yes, in exceptional cases, while the assessment continues. Document the reason in writing for funding clarity.

Last reviewed 2026-06-21. Clinical reviewer pending appointment (target Sep 2026); meanwhile reviewed by the editorial team.