Author and Publication
Author: Ben Slater, Registered Social Worker, Founder and Managing Director of Nellie Supports
Reviewed by: Kerry Slater, Director of Operations
Last reviewed: 20 July 2026
Citation
1. Department of Health and Social Care (2022) National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Available at: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
2. Department of Health and Social Care (2022) NHS Continuing Healthcare Fast Track Pathway Tool.
3. Department of Health and Social Care (2022) NHS Continuing Healthcare Decision Support Tool.
4. R v North and East Devon Health Authority, ex parte Coughlan [2000] 2 WLR 622.
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
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This article does not constitute legal advice, clinical advice or a substitute for a decision-specific professional assessment. Where legislation, government guidance, court forms or external professional materials are referred to, those materials remain subject to their own copyright, licensing and re-use terms.
Abstract
This guide explains who can complete an NHS Continuing Healthcare Fast Track Pathway Tool. It sets out what an appropriate clinician means, which professionals typically complete the tool, who cannot complete it, what the clinician must record, how to request completion, and what to do where no clinician will take it forward.
Who can complete a Fast Track Pathway Tool
Fast Track is only available where an appropriate clinician completes the Fast Track Pathway Tool. Knowing who qualifies, and what they need to record, is often the difference between a swift outcome and weeks of delay.
What an appropriate clinician means
The Framework requires the tool to be completed by an appropriate clinician, meaning a registered nurse or medical practitioner who is responsible for the diagnosis, treatment or care of the individual. The requirement is both professional registration and genuine clinical responsibility for that person, rather than simply holding the right qualification.
Who typically completes it
In practice this is often a hospital consultant, a hospital or community palliative care nurse specialist, a hospice doctor or nurse, a district nurse, a GP, or a specialist nurse involved in the person's condition. Palliative care teams complete a large proportion of them, because they are usually the clinicians closest to the person at that stage.
Who cannot complete it
Social workers, care home managers, therapists and family members cannot complete the tool, however well they know the person. Nurses and doctors without clinical responsibility for the individual also fall outside the requirement. That said, anyone can raise the question and ask an appropriate clinician to consider whether the tool applies.
What the clinician must record
The tool requires a clear statement of the clinical rationale: that the individual has a rapidly deteriorating condition that may be entering a terminal phase. The reasoning needs to be specific to the person rather than generic. A tool returned as incomplete is one of the most common causes of delay, and it usually turns on thin or generic reasoning rather than on eligibility.
How to request it
Ask the clinician most involved at the relevant time, which is usually the palliative care team, the hospital consultant or the GP. Explain the trajectory you are seeing rather than asking generally about funding. If the first person approached declines, ask another clinician involved, since views on timing legitimately differ between professionals.
If nobody will complete it
Ask for the reason to be recorded. Where a clinician considers the criteria are not met, that is a clinical judgement rather than an administrative refusal, and a second opinion from another treating clinician is a reasonable next step. If the trajectory is not yet clear, the alternative is the standard route beginning with a Checklist, which should not be delayed while the question is considered.
What happens next
A properly completed tool should be accepted by the Integrated Care Board and funding put in place urgently, without a Decision Support Tool or Checklist. The Board is not expected to second guess the clinical judgement of an appropriate clinician, and returning a properly completed tool for further evidence is a point worth challenging directly.
Key takeaway
An appropriate clinician is a registered nurse or doctor with responsibility for the person's diagnosis, treatment or care. Ask the clinician closest to the situation, make sure the rationale is specific rather than generic, and use the standard route in parallel if the trajectory is unclear.
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Frequently asked questions
Can a GP complete a Fast Track tool?
Yes, where the GP has clinical responsibility for the person's diagnosis, treatment or care. GPs, hospital consultants, palliative care specialists and district nurses all commonly complete the tool.
Can a social worker complete it?
No. The tool must be completed by a registered nurse or medical practitioner with clinical responsibility for the individual. A social worker can raise the question and ask an appropriate clinician to consider it.
Can a care home nurse complete it?
Potentially, where they are a registered nurse with clinical responsibility for that person's care. In practice the Board may look for input from the treating clinician, so involving the GP or specialist team helps.
Related NHS Continuing Healthcare pages
These links take you to the most relevant Nellie Supports service page and to the supporting guides that explain the surrounding process.
Speak to an independent CHC specialist
Nellie Supports prepares independent needs evidence for NHS Continuing Healthcare assessments, reviews and appeals across England and Wales. Our reports are written by registered social workers on a permanent employed team, with internal peer review before release. Call 0333 987 5118 or send an enquiry and we will talk through where you are in the process.