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Wednesday, 01 November 2017

'Fast track' care service for terminally ill people 'not working quickly enough'

Written by Ella Pickover

Terminally ill patients could be dying in hospitals due to delays with a "fast track" service aimed at helping people receive care outside of hospital, a new report suggests.

The Continuing Healthcare package, funded by the NHS, is for some people whose health needs can be attended to outside of hospital.

Some cases are put on a fast track route - recommended to take place within 48 hours - to enable the terminally ill to return to their own home or care home.

But a new report from the charity Marie Curie raised concerns that the service was not operating quickly enough.

In some instances patients are being delayed in hospital, and potentially dying there, as they wait for the care package to be put in place, the authors said.

The charity has estimated that in 2015/16 as many as 57,000 people waited longer than two days for a package of care, of which just over 25,000 were waiting longer than a week.

Simon Jones, director of policy and public affairs for Marie Curie, said: "Fast-track CHC is crucial to seriously ill and dying people.

"It supports them with the care they need to get out of hospital and will often mean they are able to die where they want to.

"Delays which lead to people waiting beyond 48 hours to get the care package they need will inevitably lead to some people dying in hospital before arrangements can be put in place, causing significant distress to them and their loved ones.

"This is totally unacceptable."

The charity sent Freedom of Information requests to NHS organisations to ascertain how many people received fast track care within the recommended time frame.

No NHS Trust was able to fully respond to the charity's questions and only 28% provided partial responses.

Only 22% of local health bodies, clinical commissioning groups (CCGs), responded in full to the data request, with a further 27% of partial responses.

Of the ones that responded, the charity found that just 28% were able to provide Continuing Healthcare within an average of 48 hours and 32% had average wait times of more than a week.

Some CCGs reported patients waiting more than two weeks to leave hospital, the charity found.

Mr Jones added: "The fact that some areas are operating within the recommended time frame demonstrates that 48 hours is an achievable performance measure.

"If a CCG in one part of the country is able to get it right, then all CCGs across the whole of England should be expected to."

Julie Wood, chief executive of NHS Clinical Commissioners, a membership organisation representing CCGs, said: "The Department of Health framework sets out that a fast-tracked CHC care package should preferably be put in place within 48 hours and CCGs led by GPs, nurses and other clinicians strive to meet this tight timeframe and get people the care they need as soon as possible.

"However, the needs being assessed are in many cases very complex and it is important that the care put in place is right for the individuals, rather than hastily pulled together before their needs are properly considered.

"Further in some cases it may be that the best care option for the person is not immediately available, which may account for short delays.

"The important thing is to make sure that people get the right care.

"We recognise however that in the case of continuing healthcare, the current framework that CCGs have to use is too complex and doesn't always reflect the environment that services are having to deliver in or lead to the best outcomes for patients.

"This is why we are working with NHS England on behalf of our members to simplify the framework and make sure that it is more consistent, enabling CCGs to provide the best possible care for patients."

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