Merseyside 24/7 end of life care project Presented by Jan - - PowerPoint PPT Presentation
Merseyside 24/7 end of life care project Presented by Jan Sutherland Oakes Director of Care Claire House Lesley Fellows Hospice to Home Manager Helen Dunning Specialist Palliative Care Nurse Outline Palliative care developments
Presented by Jan Sutherland Oakes – Director of Care Claire House Lesley Fellows – Hospice to Home Manager Helen Dunning – Specialist Palliative Care Nurse
Palliative care developments – Merseyside
& Cheshire
Issues and challenges – pre project Opportunities Aim of the project Project Partners Delivery of project Benefits Project evaluation 2014/15 Summary
Small number of deaths in each area (estimated 11 deaths per CCG)
Unpredictable nature – peaks and troughs in disease trajectory
Skills, confidence and competence – difficulties maintaining skills when exposure limited
Changing roles for CCN’s e.g. GP referral, early discharge/admission avoidance
Capacity to step up to 24/7 – often existing services are weekday/daytime cover
Funding / financial constraints
Sustainability – may need to provide EOLC for weeks/months
Opportunity for economies of scale Merseyside QIPP Project Opportunity for statutory and
12 month funding secured through
Collaborative project plan
To develop systems to support 24
Child and family
Specialist Palliative care team Claire House H2H service Community children’s nursing teams GP
Funding for project allowed additional
human resources for the Hospice to Home team
Steering group formed to oversee
governance issues and track progress– included SPC Consultant; commissioners from NHS Merseyside CCG’s; CEO/Director
manager (H2H manager); Specialist palliative care nurse; CCN representation
Stakeholder group formed to discuss cases
and operational issues – Nurses from each CCNT; H2H nurses and SPCT
Scoping exercise was undertaken to find
24/7 EOLC service
shared handover of patients receiving EOLC; key communication messages
Togeth er er we achie ieve more for childre ldren and famil ilie ies
Child/family Providers in the project Commissioners
Home is always a realistic option for EOLC Rapid access to specialist palliative care advice Cost effective collaborative commissioning Continue to be supported by local services who know the child/family well Governance reassurance for lone working and medicines management Insurance policy approach Access to specialist symptom assessment and management 24/7 Education and training for CCNT Sustainability of services Access to therapy services from Hospice, counselling, play, music and complementary therapies Rapid access to 24 hour 7 day a week nursing care Sibling support Improved communication between teams due to collaborative working Single point of contact Financial investment to
23% 41% 23% 23%
Referrals
Knowsley South Sefton Liverpool St Helen's Halton
100 200 300
Total number of nights of EOLC
Claire House 11% Home 67% Hospital 22%
Place of death
Claire House Home Hospital 2 4 6 8 10 Died Care stepped down Ongoing
Outcomes
The pilot evaluation presented to all 6 Merseyside CCG lead nurses & Commissioners
Agreement reached that service provision was a cost effective option to providing a realistic and responsive 24/7 end of life care service
Model facilitated realistic choice for end of life care at home
Service commissioned across the 6 Merseyside CCG’s on a population basis
Service specification and service level agreement
Quarterly reports and annual overview
Model of service provision / commissioning offers
palliative care
NHS England potential funding options
Population based Service based Outcomes and performance