Continuing Healthcare Team 1 Standard Court Park Row Nottingham NG1 6GN Telephone: 0115 883 9580 Email: [email protected] 20th September 2019 Dear Colleague, I am writing to you regarding the Fast Track Pathway Tool for NHS Continuing Healthcare (CHC). The CCGs regularly monitor and audit the use of the Fast Track Pathway Tool according to locally agreed processes. A recent audit has identified that there has been an increase in Fast Track referrals that do not fulfil the referral criteria. Therefore, this correspondence is to re-energise key messages for colleagues. Criteria for Fast Track for NHS Continuing Healthcare: The criteria are satisfied when an appropriate clinician concludes that the person has: ⋅ A rapidly deteriorating condition ⋅ The condition may be entering the terminal phase (e.g. prognosis of days/ weeks) ⋅ The person has a primary health need ⋅ The person needs CHC funding to urgently meet their care needs ALL of the above must be satisfied. The Framework is clear that where there are local end-of-life pathways these may be appropriate and therefore not everyone at the end of their life will be eligible for, or require, NHS Continuing Healthcare. The Nottinghamshire picture: ⋅ The number of fast track referrals and associated cost has risen significantly over the last 2 years. ⋅ Audit shows that forms are poorly completed and eligibility criteria sometimes not met. ⋅ Core services not always being used. ⋅ It is not clear if everyone completely understands the often complex Fast Track and CHC processes. Why are we doing this? There are some very specific implications of inappropriate use of Fast Track: ⋅ Providers charge an enhanced rate for packages/ placements arranged as part of fast track even if the care delivered is unchanged and provided in the same setting. ⋅ If core commissioned services are not used when appropriate instead of Fast Track then the CCG is paying twice. ⋅ There is a risk that the person may have to transfer to a different provider or be unable to continue with the care if eligibility changes at review. The Nottingham and Nottinghamshire CCGs are Mansfield and Ashfield, Newark and Sherwood, Nottingham City, Nottingham North and East, Nottingham West and Rushcliffe Clinical Commissioning Groups. Accountable Officer: Amanda Sullivan What form do I complete and where is it? The revised Fast Track Tool October 2018 should be used in conjunction with the National Framework for NHS Continuing Healthcare and NHS- Funded Nursing Care, 2018. This is a national standardised document therefore there should be no alterations to this document. Following the audit of fast track referrals undertaken during the summer 2016 work was undertaken to design a more user friendly form that is compatible with SystmOne and EMIS. The new form has been developed with the involvement of GPs and a number of the fields will auto-populate using information already in SystmOne or EMIS. The new referral form is accessible from the amber page of the EPaCCS template as seen below: For clinicians unable to access either SystmOne or EMIS a word version of the document is available below: Could you please ensure the attached One Page Guide to Continuing Healthcare Fast Track Referrals is made available to all referring clinicians within your organisation? Fasttrack Form.odt Thank you for your support. Yours Sincerely, Rosa Waddingham Deputy Chief Nurse and Associate Director of Personalised Care The Nottingham and Nottinghamshire CCGs are Mansfield and Ashfield, Newark and Sherwood, Nottingham City, Nottingham North and East, Nottingham West and Rushcliffe Clinical Commissioning Groups. Accountable Officer: Amanda Sullivan .