Anyone know anything about the criteria for fastrack community care plans?

[HauntedLittleLunatic]

My step dad has had motions put in place for the above.

He has cancer and now pneumonia and has been in hosp for 10 weeks and has asked to go home. They had given a prognosis of 6-9m but are now planning pain mangement palliative care only. He is on a DNR.

We haven't managed to get anyone to commit to a .we prognosis except that 6m is optimistic. Can anyone give any guidance on criteria (which I have read and know that he has to be in terminal phase to be fast-tracked).

I know no-one can say for sure. And I know that he may be being fasttracked because of the pneumonia but not necessarily the cancer (he also has copd and an aggressive lung primary tumour).

Realistically what are the criteria for 'terminal phase' we have relatives abroad with flights booked for 4 weeks time. I am worried that that will be too late and also looking to help prepare other family members.

I'm really sorry to say but I was under the impression that to qualify for fast track means less than 12 weeks.

Thats fine. It's a better prognosis than I was expecting tbh. Just wanting to 'know' IYSWIM

Sorry do you mean continuing healthcare ?

A community care plan is just the local authority document as to how they will meet any assessed and eligible needs.

Are you trying to get him home ?

Palliative services are usually if prognosis approx 12 weeks or less.

You could apply for attendance allowance under special rules

I mean fastrack getting him out of hospital and into his house whatever the formal for that is.

Wheels are in motion can't fault them in responding to his wishes. I am just trying to interpret what all this means in terms of a 'numerical' prognosis.

Attendance allowance in hand.

Has he had an assessment of care needs ? Will he need a hospital bed and equipment to go home ? If so he will need an occupational therapy assessment. Does the hospital have s a discharge co- ordinator ?
Speed of discharge depends on a lot of things

It is often impossible to get a firm prognosis as is often wildly inaccurate

I know prognosis is not exact. Just trying to establish if timescales are weeks or days (or unlikely months).

Has seen OT. hosp bed arriving Fri or Mon. Care package (is that the social worker bit?) Being sorted but don't know details on that yet. Things just seem to be happening at lightning speed at the moment.

yes the care package is the SW bit so speak to them to find out what is going on......unless he has Contiuing Healthcare funding where all costs met by health.

If you ring the SW dept at the hospital they will be able to advise you

Hi, I've got some knowledge in this area. First of all I'm really sorry to hear how ill step Dad is and that you're dealing with all this.
The fast track system is set up for patients with complex palliative care needs, I.e. greater than a typical social service care package can provide. Life expectancy is such a difficult subject. Generally doctors are over optimistic tbh. The problem is you never know what will happen like additional infection - for example, my Mum had ovarian cancer but she died because she got septic from an infection in her urostomy bag, not something people could have predicted. So It's really hard to say..I would hope your family will be in time to see him but sadly no-one can give that guarantee. The reason they're being vague is simply because they just don't know :(
The fast track is put in place and then reviewed - I think after 4 weeks. It can get the support he'll need after discharge, I think it's 21 hours a week in total? Which is a lot more than SS can provide. He'll also be entitled to district nurse input and it's worth seeing what local hospice provision is available. Does the hospital have a Palliative Care Discharge Liaiason Nurse or similar? They should be guiding you through the process.
I hope that helps a bit.

Oh and I believe fast track funding is different from social service and continuing care fully funded - it's a separate pot of money specifically for end of life patients to get them out of hospital/ provide care in the community urgently.

Thankyou for all that help.

We know that the 6m is optimistic because that was the prognosis before they decided to withdraw (not start) treatment.

I was just trying to understand what the severity has to be in order to qualify for this level of care, which you have helped with....things seem to be happening at lightening speed since decision to go home was made yesterday. It is however made more complex because he is in a hospital 90 miles from home in a different PCT but we are getting there.

Hi haunted, I just wondered how things are? Did your stepdad get home ok? Thinking of you and your family.

Ty.

He is home.

He has had a syringe driver fitted today, we are aware that things are moving on.

Thanks for thinking of us.

I'm glad he's got home. Syringe drivers are brilliant, my DMum had one and I'll always push to get my patients on then because they manage symptoms so well. I just found myself wondering how things were - you're very welcome. Feel free to PM me if you want any more advice (or just somewhere to talk!). Make sure you look after yourself too.

Ty. Hopefully things will settle. He has had a shit 24 hours - but then he was without pain relief for 18hrs before syringe driver was fitted.