Case study:

16 February 2009

Introduction and use of a fast track tool for NHS-funded continuing healthcare in Somerset PCT secondary care settings

Key points

Hospital staff within Somerset PCT are now using a fast track tool to discharge patients to NHS-funded continuing healthcare in local hospices when this is their choice.

Use of the tool has increased the number of appropriate applications relating to both training and the introduction of the new framework and led to near 100% occupancy of NHS-funded continuing healthcare hospice beds. This has been achieved through a combination of direct discharges from secondary care, admission from hospice beds and admissions from the community.

The fast track tool, part of the National Framework for NHS-funded Continuing Healthcare introduced in October 2007, is used to help discharge dying patients from secondary care to the most appropriate setting and can result in same day discharge in some cases.

Senior nurses, matrons and specialist palliative care nurses in secondary care received training on how the tool worked. This was followed up with workshops about the application process to ensure it fitted working practices in both primary and secondary care.

Training was also delivered to hospice staff and community palliative care nurses to ensure they know how to access NHS-funded continuing healthcare appropriately.

The framework is currently under review and if there are fundamental changes as a result, a plan to deliver update training to all parties will be put in place.