Fast-Track NHS Continuing Healthcare: Free NHS Care at the End of Life (2026)

In short: if someone's condition is getting worse quickly and they may be entering the last stage of their illness, a doctor or nurse can complete the fast-track pathway tool. This makes them eligible for NHS continuing healthcare straight away, without the usual assessments. The NHS then pays for their care in full, and the care package should usually be in place within 48 hours.

What is NHS continuing healthcare?

NHS continuing healthcare (CHC) is a package of care for adults that is arranged and funded solely by the NHS. It is free to the person receiving it, and it is not means-tested, so it does not depend on how much money the person has. It can be provided at home or in a care home. In a care home it can pay the fees. At home it can pay for carers to help with things like washing, dressing and eating. It does not pay for food, clothes, rent or mortgage payments, or utility bills.

Most people go through a checklist and then a full assessment, and a decision should usually be made within 28 days. The fast-track route skips both for people near the end of life. Our guide to NHS continuing healthcare explains the standard route.

Who qualifies for fast-track?

The fast-track pathway tool is for someone who has a rapidly deteriorating condition that may be entering a terminal phase. The national framework says:

• there should be no strict time limits based on how long someone is expected to live;
• "rapidly deteriorating" should not be read narrowly as meaning only a short, specific time left;
• "may be entering a terminal phase" is not limited to cases where death is imminent;
• it can be used in advance if someone has few symptoms now but rapid deterioration is expected soon.

The decision belongs to the clinician completing the tool. A prognosis should be included where one is available.

Who fills in the fast-track form?

Only an "appropriate clinician" can complete it. That means a registered nurse or doctor who is responsible for the person's diagnosis, treatment or care and knows their health needs. This can include clinicians working for hospices.

Families, carers and other people supporting the person cannot complete the tool themselves. But they can ask the person's GP, district nurse, hospital doctor or hospice nurse to consider it. You do not need a checklist or a full assessment first.

What the NHS must do

The completed tool goes to the local integrated care board (ICB), the NHS body that pays for continuing healthcare. The national framework says:

• the ICB must accept and immediately act on a properly completed fast-track tool;
• the care package should be agreed and arranged urgently, and this should not usually take more than 48 hours from when the ICB receives the tool;
• care should not be delayed while the ICB sorts out any concerns about how the tool was used;
• the ICB should not demand extra details about how the condition will progress before agreeing funding.

Only in exceptional cases, for example where the form doesn't describe a rapidly deteriorating condition at all, should the ICB go back to the clinician for clarification. Marie Curie says that in practice some areas can take longer than 48 hours. Ask the GP or nurse how long it is likely to take where you live.

Where the care can be given

Fast-track funding can be used in any setting, including the person's own home, a care home or a hospice. The framework says the aim is for the person to get the support they need in their preferred place as soon as reasonably possible. That includes someone in a care home who wants to go home to be with family.

If a care home is the right place, our directory lists nursing homes near you, and palliative and end of life care in a care home explains what to ask.

Can fast-track funding be stopped?

The NHS reviews care packages, and in some cases it may review eligibility. The framework says:

• reviews of eligibility in fast-track cases should be made with sensitivity;
• if the person is expected to die in the very near future, the ICB should keep paying until the end of their life;
• funding should not be removed unless eligibility has been looked at again through a full assessment by a team of professionals;
• the person must be told in writing about any proposed change, and of their right to ask for a review.

Help with benefits

If a doctor or nurse has said someone over State Pension age might have 12 months or less to live, they can claim Attendance Allowance under the "special rules for end of life". Ask the doctor or nurse for form SR1. Under these rules the higher rate of £114.60 a week is paid, and there is no face-to-face assessment. Someone else can claim on the person's behalf.

Marie Curie says that if the NHS pays someone's care home fees, Attendance Allowance usually stops after 28 days. If they get continuing healthcare at home, it stays the same.

Getting help if things go wrong

Beacon gives free, independent advice on NHS continuing healthcare, funded by NHS England. Call 0345 548 0300. You can get up to 90 minutes of free personal advice from a trained adviser.

Scotland, Wales and Northern Ireland

This guide covers England. Marie Curie says NHS continuing healthcare is available in England and Wales. Scotland stopped using it in 2015, and Northern Ireland provides continuing healthcare through social care packages. Ask the person's GP or nurse what applies where they live.

Related guides

• End of Life Care at Home: Arranging Support in the UK
• Hospice, Care Home or Home: Choosing Where to Be Cared For at the End of Life

Sources

• NHS continuing healthcare (NHS)
• Fast-track pathway tool for NHS continuing healthcare: guidance (DHSC, GOV.UK)
• National framework for NHS continuing healthcare and NHS-funded nursing care (DHSC, GOV.UK)
• NHS Continuing Healthcare (NHS England)
• NHS continuing healthcare (Marie Curie)
• Claiming Attendance Allowance if you're nearing the end of life (GOV.UK)