improving end of life care in leeds 15 th june 2009 angela gregson practice and professional...
TRANSCRIPT
Improving End of Life Care
in Leeds
15th June 2009
Angela Gregson
Practice and Professional Development Lead
Palliative and Continuing Care
Background
• March 2006 - Marie Curie Delivering Choice Programme
• October 2006 – merger of previous 5 PCTs to become 1 – Leeds PCT
• 2006 - Review of Continuing Care Provision citywide
Service Delivery Framework Development
Why?Required to address gaps/inconsistencies across the cityRecommendation from review of Continuing CareNeed to put DNs back at the centre of care delivery – key worker role.Review of DN service – “Moving Forward”
Service Delivery Framework DevelopmentHow?Engage key stakeholders March/May 2007 - two workshops held – cross city/discipline representation Draft framework developed – presented to critical friends July 2007 – education planned Nov/Dec 2007 – mandatory training delivered January 2008 – SDF launched
Complex and Palliative Continuing Care Service(CAPCCS)
• One of the outcomes of the workshops held to discuss Palliative Care and service delivery
• Steering group formalised
• Structure of new citywide service determined Sept 07
• Merger of District Nurse Relief and Support Team(NW) and ELIPSC(East) Oct 07
• Recruitment Process Nov 07
• CAPCCs to begin operationally Jan 2008
CAPCCSReferral Criteria
• ELIGIBILITY CRITERIA CAPCCS will accept individuals based on the
following eligibility criteria:
• Aged over 18 years
• Registered with a Leeds GP
• Meet continuing care criteria for fast track status
• Have an individual business case written and agreed for on-going complex
continuing care need
under the care of the District nursing service
Partnership workingPalliative Care - Case History 1
Tuesday - Very ill patient in hospital wishes to come home to die
Ward contacted CAPCCS and care planning meeting arranged
Wednesday – Meeting with ward staff, Social Worker, District Nurse, CAPCCS Senior Nurse, patient and daughter.
Marie Curie Ambulance booked, Meet & Greet booked, DN/CAPCCS visits arranged
Thursday – Patient discharged home and spent 2 ‘precious’ days with her family before she died peacefully.
CAPCCS Complex Care - Case History 2
• Patient with complex continuing care needs in hospital for 2 years
• Wishes to be looked after at home
• Working Group set up & Business case prepared
• Framework developed & robust Governance arrangements
• Team of carers appointed
• Patient now home with family
CAPCCSBenefits / Acheivements
• Enhance District Nursing Service to ensure service sustainability
• Facilitate patient choice• Prevention of Hospital admissions for complex and
palliative care patients• Facilitate timely patient discharge• Patient with complex needs looked after at home• Create a supportive environment for patients and
care providers • Ensure quality, safety, compassion and efficiency
at all times
Improving access to Palliative Care within BME communities
NHS Leeds BME Network
• Network was established in March 2004• Made up with BME staff working at all
levels within the PCT and the Acute Trust
BME Network Vision
BME Network
Empowering staff
Patient focused care
Sensitive to patients needs
Awareness of cultural diversity
Improving access to Palliative Care within BME communities
• Identified within Phase 1 of MCDC programme as an issue in Leeds
• Established as one of the workstreams of the programme
• Link worker appointed October 2007• Reference groups established in LS 11 and
LS7• Workshops and events • Mainstreamed into Patient and Public
involvement
The future
• Further embedding of Service Delivery Framework
• Development of CAPCCS• Verification of expected death• DNAR/FAST Track sign off by RNs• Increased uptake from within BME
communities of palliative care services
Outcomes
• Equity across patient population of Leeds in terms of palliative care delivery
• Patients able to die in their Preferred Place of Care
Discussion
Any questions?
