End of life: NHS CHC Fast Track care home
The NHS Continuing Healthcare (CHC) Fast Track Pathway Tool is designed for one situation: rapidly deteriorating, entering a terminal phase. The form is short. The funding is total.
The short answer. A consultant, GP, hospice doctor or senior palliative nurse can sign the Fast Track Pathway Tool. The legal target is a decision within 48 hours of submission. Once approved, the NHS pays for all care in a hospice, care home or at home. There is no means test. The form is named in the National Framework and the template is public.
The 48-hour timeline
Hour 0
Senior clinician completes the Fast Track Pathway Tool.
Hour 0-24
Form submitted to the Integrated Care Board CHC team. Care can begin immediately.
Hour 24-48
ICB decision recorded. CHC team identifies a hospice or nursing bed.
Day 3-7
Transfer happens. Care is fully NHS-funded for as long as needed.
Review
Reviewed at 3 months by default. If the patient stabilises, transferred to standard CHC pathway.
What the form needs
The Fast Track template is short and unambiguous. The clinician must record that the patient has a primary health need, is in a rapidly deteriorating condition, and may be entering a terminal phase.Fast Track Pathway Tool ↗
What CHC Fast Track pays for
- Care home or nursing home placement, full weekly rate.
- Hospice bed, full daily rate.
- Home care including night sits.
- Specialist equipment (hospital bed, pressure mattress, syringe drivers).
- Continence supplies and dressings.
If the patient stabilises
Fast Track is reviewed at 3 months by default. If the patient is still alive and stable, the case is re-assessed under standard CHC, which may continue funding or transfer to the council. The patient is not retrospectively asked to pay for the Fast Track period. CHC Framework ↗
Frequently asked
Can a GP sign the form, or only a hospital consultant?
Any senior responsible clinician can sign, including a GP, hospice doctor or senior palliative nurse. The form is not restricted to hospital teams.
What if the ICB misses the 48-hour target?
The 48 hours is a legal target, not a hard deadline. If it slips, the patient and family can complain to the ICB and to the Parliamentary and Health Service Ombudsman.
Does the family have to pay anything?
No. Fast Track care is fully NHS-funded with no means test.
Last reviewed 2026-06-21. Clinical reviewer pending appointment (target Sep 2026); meanwhile reviewed by the editorial team.