Background NHS Continuing healthcare [CHC] is the name given to funding of care which is arranged and funded solely by the NHS for individuals outside of hospital who have ongoing health care needs; the ‘fast track CHC pathway’ is a tool to enable the immediate provision of this care for patients who are deteriorating rapidly or who are actively dying (NHS Website). There is no timeframe for prognosis in the National Framework when considering eligibility for NHS Fast Track Funding.
Aims To review diagnostic trends in patients referred for fast track funding, the appropriateness of applications made by the hospice community team and the impact on place of death.
Method We recorded all fast track CHC funding requests made by the hospice community team between 1st June 2017 and 31st May 2018, recording date of request, date of death, place of death and diagnosis. We compared this to the whole population of patients referred to the service in that time.
Results 71 patients had a fast track CHC funding request made. 68 had a cancer diagnosis. 63 have died. Of those who have died, the range [in days] from application to death was 1–109 days. 36 [57%] died within two weeks of the application, and four were still alive at 12 weeks. 36 died at home, 17 in the hospice inpatient unit, three in an acute hospital, one in a community hospital and six in a nursing home.
Conclusions and discussion When compared with our annual data, more patients died at home [57% vs 44%] and fewer died in hospital [6% vs 17%]. Nearly all of the patients had died within 12 weeks [the standard review period] indicating an excellent assessment of likely prognosis. However, with over half dying within two weeks of completing the request this raises the question: should we be requesting funding earlier?
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