an alternative perspective from the third sector
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An Alternative Perspective from the third sectorJo StradlingDivisional General Manager, Central & Eastern England
An Alternative Perspective from the third sector
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• Different models for end of life care
• Cost effectiveness of home care
• Benefits to Patients
• Lessons from Integrated Systems
Current Position
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47% of deaths take
place in hospital
30% of bed occupancy in last year of
life
Number of deaths due to rise 17% by
2030
Basic demand pressures will
not change demography
and morbidity… but we can change the
supply factors Best systems in UK
International Perspective…
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% of deaths taking place in hospital:
New Zealand28.1%
Context:• System• Funding mechanisms• Societies attitude to death
• Qualified workforce• Palliative care is free • Universal access • Low percentage of deaths
taking place in hospital
Netherlands24.6%
Kinds Fund Study on the Sustainability of Social Care Services
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Key findings from: Social Care and Older People – The Home Truths• Social Care system in its current form is struggling to meet the needs of
older people• Huge pressures on the social care market• Access to care depends increasingly on what people can afford- and where
they live – rather than on what they need• There is a widening gap between needs and resources set to reach at least
£2.8 billion by 2019
Three major strategic challenges:• Achieving more with less• A different offer• Long-term reform
https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Social_care_older_people_Kings_Fund_Sep_2016.pdf
Deaths in hospitals are an unnecessary burden on our struggling healthcare system Huffington Post article by Dr Jane Collinshttp://www.huffingtonpost.co.uk/dr-jane-collins/nhs-crisis-marie-curie_b_14145006.html
Care and support needs of those who are dying in UK, are being fundamentally neglected
Care packages are not put in place in time for hospital discharge
Need to recognise the role of social care at end of life
Ironically, these failures in terms of transferring care often mean that the NHS will spend more money on costly hospital treatment.
Also, more cost effective to die at home and mostly personal preferences
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Simply doing more of the same is not
sustainable!
Exploring the cost of care at the end of lifeNuffield trust research report 2014
http://www.nuffieldtrust.org.uk/sites/files/nuffield/publication/end_of_life_care.pdf8
Two thirds of patients saw their GP at least once during last three
months of life
40-50 minutes of district nurse time per day in last few
days of life.
Just over a quarter of people used local
authority funded social care in final
year of life
Hospice costs est £550 per person
Hospital cost for final three months of
life = £4500 per person
Hospital costs are highest
Community Alternatives
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Primary Care
District Nursing
Social Care
Home CareIncreased
complexity of provision
Drivers and incentives not
aligned
Community
Benefits to patients through successful commissioning
Personalised care planning
Coordinated care and support
including information
Rapid access to specialist
advice
Services that treat people as
individuals, and with
dignity and respect
Services that acknowledge patient and
carers as part of the care
team
Equality of access
Experience of services of a
consistent high quality
PATIENT CHOICE
Exploring the cost of care at the end of lifeNuffield trust research report 2014 continued…
People who received care from our Marie Curie Nursing service…
….had a lower average
hospital costs of £1140 per
person.
…spent two and half fewer
days in hospital
during last 90 days of life.
…were less likely to need emergency
hospital care (12% vs.
35%)
… were less likely to die in hospital (8%
vs. 42%)
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Community Nursing – rethought
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Overnight Service
Rapid Response
Companionship
Helper
Hospices – Rethought
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Inpatients
OutpatientsOne Stop Shop / Holistic Care / Different Environment
Day Therapy
Rehabilitation
Integrated Provider
Contact details
Website: https://www.mariecurie.org.uk/
Information and support line:
0800 090 2309
Questions?