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Fast Track Discharge... - Carers UK Forum

Fast Track Discharge...

All about money
Feedback please….
My father is back in hospital (sadly) having suffered another major UTI (and sepsis, as well as a chest infection.) However, on speaking to the doctors today for an update, they are ‘preparing for all eventualities’ including a rapid decline if he doesn’t rally in the next 48 hours. (Kidneys damaged from retention and also his cancer is spreading rapidly.) They asked if I knew my fathers wishes should he not recover well and it would be necessary to put in place a palliative care package for him.
There was a mention of a Fast Track discharge….
I asked the doc to explain it to me at least twice as it is all gobble de gook to me and this is my first time round with all of this. Also I don’t trust the Social Services after my previous experience in the summer when my father was discharged home incorrectly IMO… (I.e without adequate care in place for him, although I took up the role and have been his full time carer since July.) But… this is the next level and I know it is beyond my capabilities..
My concern is I know nothing about this fast tracking apart from what I have read quickly on an internet search and a few posts here about this…
I am guessing much of it has to do with funding too..
He has over £23,000 savings, so I am thinking we will have to privately fund?
But IF he needs continuing care? A friend, (who has been through this with her mother in recent times) said that this is state funded and not means tested.
I don’t want to make the wrong decision and am looking for a bit of guidance.
(We also talked about the local hospice where I know my father would consider going, he gives a donation each month, but I think his wishes are to return home with adequate care in place and not to a nursing home, if he is not quite at the final stages.)
So many decisions to make!
Hi,
I think they meant 'fast track continuing health care', that is, everything will be paid for by the NHS. You should apply for this as soon as possible. Others are more up to date on this than I am. But I got CHC for my brother some years ago - it is a postcode lottery, but they are much quicker to give it if the person really is at end of life. I'm sorry to hear about your father. This way he would at least not have to fund his treatment outside hospital.
Focus on what he NEEDS, not what he wants.
I know it's horrible to do, but Google Signs of Dying. Consider how you would manage his needs at home?
Is there room for a hospital bed downstairs, for example?
Ask the doctors how long he has left.
When his time comes, you will need to use a funeral director.
Have you thought about how much this will cost, which one to use?
Are you in a high or low Covid area?
This may affect the amount of community support available?
Don't put off these things, have a notebook and write things down you want to ask.
Many thanks to both of you. Digested and understood. I 'hope' he will have a few months more at least, as he has rallied in past 24hours, but the cancer is spreading fast and is now officially terminal, (on a fast scale, not the 'slow and he will likely pass of something else' type!!!
Yes, I am making lists day and night and using the time whilst he is in hospital to have in depth conversations with people, (such as undertakers etc.) I know my father's basic wishes, but there are many details he has not set down, but I will have to wing it and hope for the best. (There really is no other family, other than his elderly sister, but she has already said she is not prepared to travel the 200 miles to us, so I will do my best to video and include her where I can.)
You are 100% correct it is what he needs to make him comfortable.
Thank you so much both..
Love and Light. W

NB My major hurdle is to get the local Adult Social Services to DO RIGHT by us where they failed miserably on his previous discharge! (I now know a lot more than I did then!!)
Fastrack NHS Continuing Healthcare is organised by the NHS, not Social Service. Try to really pin the hospital down about this.
Thanks Bowlingbun.. this is what I am having a huge problem with!
I received a call from the discharge team this morning, who said Fast Track was on the list, then the Doctor on duty said
it was not suitable for him!!????
I feel I am being fobbed off!!!
I have confirmed he will be getting the first six weeks 100% paid for regardless of which system he is discharged under. It has also been agreed (verbally at least, the home assesement still has yet to take place, 4 carer visits during the daytime. Night time I will have to cope on my own.)
It would appear that due to Covid? EVERYONE is being offered this and it is not means tested.
(But then two different friends, who have been through this too, said this was standard practice anyway pre Covid?)
Totally confused!
The Discharge Team lady mentioned the NHS? Clinical Commission policy during these times?

A home assessment, any equipment needed (bed, commodes etc) will be put in place before my father is discharged. (I have insisted on this!) I am also asking for anything we agree to be put in writing from now on. (I am fed up with being told one thing and another strangely happens?)

(NB I was asked at the start of the call did my father want to go straight to a Nursing Home, but I know that is not his wish. So I am organising a return home for now.) We agreed - the discharge team person and I, that a review of everything would take place at the six week mark. I think if I was not coping, I would have to look at a home for my father after all, but I will do my best.
Marie Cure have offered a FREE over night service 10pm to 7am two or three nights a week, but this is by referral only and also only at actual end of life. I understand this is the last 12 weeks.. or thereabouts. So not quite at this stage yet, but good to have all this info to hand.)
Update.. My father is now home.. after being ready to come home since Friday last week! It has taken seven whole days to get him a suitable care package, only for me to find that I am likely being shafted by SSvcs etc.. I agreed to have my father home on the basis of the six weeks paid for package, then we would assess things.
He comes home, the home assessment (SSvcs not CHC) takes place, they then drop the bombshell, it is only paid for for two weeks, then we have to pay! (As my father has over threshold.)

I am desperately trying to get a CHC assessment via the District Nurse or GP.

I cannot believe these people!
BTW it is a postcode lottery in our area. If we were just one mile down the road (and fully under Portsmouth) everything would be paid for no questions asked!
(But we are one foot in Portsmouth due to group practice our local GP's is under and half in county one due to our postcode. Crazy!)
It's supposed to be six weeks. I reclaimed £8,000 from Hampshire on mum's behalf after they applied the rules incorrectly.
Thank you. Update.. .
District Nurse said she is dealing with CHC application, but it could take several months?
Will have to call in the Fast Track Card if my father deteriorates. He has rallied for the moment, but
it is all a guessing game which way he will go next.
Ask her to do the Fat Track, care provided in 24 hours. It I'll be reviewed later anyhow. I think he GP makes the fast track application, not the DN.