NHS Continuing Healthcare

NHS CHC Fast Track: what to do if a referral is refused or funding is reviewed

A plain-English guide to the NHS Continuing Healthcare Fast Track pathway, what the official rules say, and practical questions to raise if access or ongoing funding is disputed.

Updated 26 August 2026

Scope: General information for England. This guide does not determine eligibility, replace the relevant NHS or Local Authority process, or provide individual legal or clinical advice.

First, understand what Fast Track is

The NHS Continuing Healthcare Fast Track pathway is for a person with a rapidly deteriorating condition who may be entering a terminal phase. It is designed to secure an appropriate package of NHS Continuing Healthcare quickly and with minimum delay.

A properly completed Fast Track Pathway Tool replaces the usual Checklist and Decision Support Tool process at that point. An appropriate clinician records why the Fast Track criteria are met and sends the tool to the Integrated Care Board (ICB).

If a Fast Track referral is not being made

There is not a single national form called a 'Fast Track appeal'. The useful first step is to establish exactly where the disagreement sits: whether an appropriate clinician has declined to complete the Fast Track Tool, whether the ICB has not acted on a completed tool, or whether existing Fast Track funding is later being reviewed.

  • Ask for the decision and reasons in writing.
  • Ask which clinician considered the Fast Track criteria and what current evidence was considered.
  • If the person's condition has changed, ask the responsible clinical team to consider the current position rather than relying on older evidence.
  • If a completed Fast Track Tool has been sent to the ICB but action is delayed or disputed, ask the ICB to explain its position and its complaints or review route in writing.
  • For urgent deterioration, raise the matter promptly with the treating team; do not rely on a website article where immediate clinical or safeguarding action is required.

If Fast Track funding is later reviewed

Fast Track eligibility does not mean that the care package can never be reviewed. The official framework expects review of the person's needs and the effectiveness of the care arrangements. If it becomes appropriate to reconsider CHC eligibility, that process should be handled sensitively and the person or representative should be told what is happening and why.

Keep a dated record of changes in needs, care interventions, risks, medication, night-time support and professional observations. The purpose is not to exaggerate need, but to make sure the current picture is accurately recorded.

Questions to take into the conversation

  • Has an appropriate clinician considered the Fast Track Pathway Tool against the person's current condition?
  • If Fast Track was not used, what evidence or criterion was considered not to be met?
  • If existing funding is being reviewed, is this a care-plan review or a reassessment of CHC eligibility?
  • What written reasons, documents and review or complaint routes will be provided to the family?