End-of-Life Care Funding
CHC Fast Track \u2014 Emergency NHS Funding
When someone is approaching the end of their life, a full CHC assessment is not required. The fast track pathway allows a single clinician to authorise immediate NHS funding \u2014 without a DST, without an MDT, and without a means test. Most families in this situation do not know it exists.
Last reviewed June 2026 · Based on the National Framework for NHS Continuing Healthcare (revised 2022).
What is the fast track pathway?
The fast track pathway is a mechanism within the CHC framework that allows urgent funding to be authorised for people with a rapidly deteriorating condition that may be entering a terminal phase.
Unlike the standard CHC assessment \u2014 which requires an MDT, a DST, and an ICB decision \u2014 fast track funding can be authorised by a single appropriate clinician: a GP, a hospital consultant, a specialist nurse, or a palliative care professional. The clinician completes a Fast Track Tool and submits it to the ICB. The ICB must arrange funding immediately \u2014 within 48 hours in most cases.
There is no multidisciplinary team required. There is no means test. There is no scoring of 12 domains. The sole question is whether the person has a rapidly deteriorating condition that may be entering a terminal phase, and a clinician believes fast track is appropriate.
Who qualifies?
The fast track pathway is available to people who:
- Have a rapidly deteriorating condition that may be entering a terminal phase
- Have needs that, as a result of that deterioration, are likely to meet the CHC threshold
The pathway is not limited to cancer. It applies to any condition with a terminal trajectory \u2014 advanced dementia, MND, end-stage heart or respiratory failure, stroke, and other progressive conditions.
Critically, “terminal phase” does not require a specific prognosis. The National Framework does not define it in weeks or months. A person can be on the fast track pathway for months or longer if their condition continues to meet the criteria.
How to request fast track funding
Fast track must be initiated by an “appropriate clinician” \u2014 a registered healthcare professional involved in the person's care. This includes GPs, hospital consultants, palliative care nurses, and specialist nurses.
The family cannot complete the Fast Track Tool themselves, but you can \u2014 and should \u2014 ask for it to be completed. If you believe your loved one is approaching the end of their life and should be receiving NHS-funded care, speak to the GP or the palliative care team and ask specifically: “Has fast track CHC been considered?”
Once a clinician completes the Fast Track Tool, it goes to the ICB. The ICB must respond within 24\u201348 hours and arrange care as quickly as possible. If care cannot be arranged within this timeframe, interim funding arrangements should be put in place.
What happens after fast track is granted?
Fast track funding covers all care costs \u2014 the same as standard CHC. The person's care is arranged in the most appropriate setting: a nursing home, a hospice, or at home with a care package.
The ICB may subsequently carry out a standard CHC review to confirm ongoing eligibility, particularly if the person's condition stabilises. If a standard review is initiated, the family should be informed and given the opportunity to participate.
If a person on fast track dies before the ICB has arranged funding, the family may be entitled to a retrospective reimbursement of care costs incurred during the delay. This is governed by the NHS's duty to arrange care promptly once fast track is authorised.
Why so many families miss it
The fast track pathway is not well publicised. Many clinicians \u2014 including GPs \u2014 are not confident completing the Fast Track Tool, or are unaware of the 48-hour ICB obligation. Some ICBs delay, despite the urgency requirement.
The consequences of this failure are severe. Nearly one in three people on the fast track pathway die before funded care is arranged. Families who have been paying privately during this period \u2014 sometimes for weeks \u2014 are often unaware that they may be entitled to reimbursement.
If your loved one is approaching the end of their life, do not wait to be offered fast track. Ask for it by name.
Frequently asked questions
Is there a time limit on fast track funding?
No fixed time limit. Fast track funding continues for as long as the person’s condition meets the criteria — a rapidly deteriorating condition that may be entering a terminal phase. Some people remain on fast track for months. If the ICB attempts to end fast track funding while the person is still deteriorating, challenge this in writing.
Can fast track be used for someone already in a nursing home who is self-funding?
Yes. If a person is self-funding in a nursing home and their condition enters a terminal trajectory, fast track CHC should be considered. The existing funding arrangement does not affect eligibility. A clinician can complete the Fast Track Tool for someone already in residential or nursing care.
What if the GP refuses to complete the Fast Track Tool?
Ask the reason. If the GP is unfamiliar with fast track, provide them with the relevant section of the National Framework (Chapter 5). If the GP believes the clinical criteria are not met, ask them to explain their reasoning and seek a second opinion from a palliative care specialist. You can also contact the ICB directly and ask them to facilitate the completion of a Fast Track Tool.