The NHS Continuing Healthcare fast track is the route to fully funded care for someone whose condition is deteriorating quickly and who may be entering the last phase of life. A doctor or nurse completes one form, the fast track pathway tool, and that form alone establishes eligibility. There is no checklist, no full assessment and no means test. The NHS aims to have care in place within 48 hours, at home if that is where the person wants to be.
Most families we speak to at this stage have never heard of it. Someone has mentioned hospices, district nurses and sometimes Attendance Allowance. Nobody has told them the NHS can fund the care itself, quickly, in the person's own home.
This article explains who can complete the form and what "rapidly deteriorating" means in practice. It then covers what happens after the clinician sends the form in Hertfordshire, and what changes once funding starts. It sits under our NHS Continuing Healthcare guide, which covers the standard route.
What the NHS Continuing Healthcare fast track actually is
NHS Continuing Healthcare is a package of care arranged and funded entirely by the NHS. It is for an adult with what the rules call a primary health need. Normally a person reaches it through a checklist and then a full assessment using the decision support tool, which can take weeks.
The fast track replaces all of that for one group of people. The Department of Health and Social Care's guidance on the fast track pathway tool is clear. Where the completed tool shows a primary health need arising from a rapidly deteriorating condition that may be entering a terminal phase, the tool "is in itself sufficient to establish eligibility". The integrated care board must then put funding and care in place without delay.
Two things follow. The decision is clinical, not financial, so savings and income are never asked about. And the person does not go through the full assessment first, which is the part that takes the time.
Who can complete the NHS Continuing Healthcare fast track tool, and who can ask for it?
Only an "appropriate clinician" can complete the tool. The guidance defines that as a registered nurse or registered medical practitioner responsible for the person's diagnosis, treatment or care. In practice that means the GP, the hospital consultant, a district nurse or a hospice nurse. Hospice clinicians count, provided they are delivering NHS services.
Anyone else can raise it. The guidance says people who are not clinicians but who support someone with end of life needs may identify that the fast track might be appropriate. That includes care workers and families. They should contact the responsible clinician and ask them to consider the tool.
That is the practical point for families. You cannot complete the form, but you can ask for the fast track pathway tool by name. Asking the district nurse or GP directly is usually the quickest way to start.
What does "rapidly deteriorating" mean, and what does it not mean?
The tool applies only where the person has a rapidly deteriorating condition and may be entering a terminal phase. The guidance is careful about how clinicians read those words.
It says nobody should impose strict time limits based on expected length of life. "Rapidly deteriorating" does not mean a specific or short time left. "May be entering a terminal phase" is not restricted to situations where death is imminent. The clinician decides on the facts of the person's needs at the time.
The guidance also allows a clinician to use the tool in anticipation. Someone may have few symptoms today while the nature of the condition makes rapid deterioration clearly likely. In that case the clinician can complete the tool with the actions agreed in advance, or set an early review date. This is often the situation families do not realise qualifies.
What happens after the fast track form is sent in Hertfordshire
Hertfordshire's continuing healthcare team now sits within NHS Central East Integrated Care Board. That board covers Bedfordshire, Cambridgeshire, Hertfordshire, Milton Keynes and Peterborough. Its published fast track process, checked on 20 September 2026, runs as follows.
With the person's consent, the clinician completes the fast track pathway tool and a clinical assessment. They ask about care preferences, including whether the person would rather be at home or in a nursing home. Both documents go to the ICB continuing healthcare team, which arranges urgent care if the person meets the criteria.
The ICB aims to have care in place within 48 hours where that is reasonably possible. It keeps the family updated on whether it can, and sends written confirmation once it agrees funding.
The national guidance adds one requirement worth knowing about. Alongside the tool, the ICB needs a care plan describing the immediate needs and the person's preferences. If the family already knows what a good day and a good night look like, that plan comes together faster.
Can NHS Continuing Healthcare fast track funding pay for care at home?
Yes. The guidance says the tool works in any setting, including where the person is already at home and wishes to stay there. The setting can also change. Someone in a care home who wants to be at home for their last weeks can move with support, and the ICB should arrange care in the preferred place wherever possible.
Two further points matter for families paying privately. The clinician should still complete the tool where a care package is already in place and could still meet the person's needs. The reason is that the person may be paying for care the NHS should now fund in full. And families cannot top up NHS Continuing Healthcare in the way they can top up council-funded care. They can buy separate private services on top, provided different staff provide them.
Starling Homecare provides visiting, overnight and live-in care at home across Hertfordshire, including for people at the end of life. The Care Quality Commission regulates us. Where a fast track package is under way, the ICB team decides how to commission the care. Our end of life care at home guide explains what those weeks look like at home, and our end of life and palliative care service page sets out what we provide.
What changes for benefits and reviews once fast track funding starts
Fast track funding is not permanent. Central East ICB says its team carries out an initial review, and the package can change if needs change. If the condition stabilises, the team may reassess eligibility through a decision support tool meeting. If the person no longer meets the criteria but still needs care, they may have to pay for some or all of it, and the council can advise.
Benefits can change. The ICB advises families to discuss this with the Department for Work and Pensions on 0800 731 0469 once continuing healthcare is in place. Attendance Allowance, including a claim made under the special rules for the end of life, is one benefit to check. Our Attendance Allowance guide explains that claim.
The ICB also confirms that a family can opt out. If the person would rather keep their current arrangements, such as family care, they can decline the fast track. The clinician can make a new referral at any time if the situation changes.
Common Questions About the NHS Continuing Healthcare Fast Track
How long does a fast track care package take to be put in place?
The NHS aims for 48 hours from the completed tool reaching the integrated care board, where that is reasonably possible. The national guidance expects the ICB to respond promptly. If nothing has happened after two days, ring the ICB continuing healthcare team and the clinician who completed the form.
Is fast track NHS Continuing Healthcare means tested?
No. Eligibility rests on the clinician's assessment of the person's needs, never on income or savings. It is not linked to any particular diagnosis either. Once agreed, the package covers the person's assessed health and associated social care needs in full.
Where can we get independent advice about a fast track decision?
Beacon gives free independent advice on NHS Continuing Healthcare on 0345 548 0300. The NHS guide to continuing healthcare also explains the process, the review timescales and what happens if the person is found not to be eligible.
We checked the rules above on 20 September 2026 against the Department of Health and Social Care's fast track pathway tool guidance and NHS Central East ICB's fast track page. To talk through arranging care at home while a clinician considers a fast track, our St Albans office is on 01727 324 127 or [email protected].
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