improving end of life care in leeds 15 th june 2009 angela gregson practice and professional...
TRANSCRIPT
![Page 1: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/1.jpg)
Improving End of Life Care
in Leeds
15th June 2009
Angela Gregson
Practice and Professional Development Lead
Palliative and Continuing Care
![Page 2: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/2.jpg)
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
![Page 3: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/3.jpg)
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”
![Page 4: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/4.jpg)
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
![Page 5: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/5.jpg)
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
![Page 6: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/6.jpg)
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
![Page 7: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/7.jpg)
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.
![Page 8: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/8.jpg)
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
![Page 9: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/9.jpg)
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
![Page 10: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/10.jpg)
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
![Page 11: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/11.jpg)
BME Network Vision
BME Network
Empowering staff
Patient focused care
Sensitive to patients needs
Awareness of cultural diversity
![Page 12: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/12.jpg)
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
![Page 13: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/13.jpg)
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
![Page 14: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/14.jpg)
Outcomes
• Equity across patient population of Leeds in terms of palliative care delivery
• Patients able to die in their Preferred Place of Care
![Page 15: Improving End of Life Care in Leeds 15 th June 2009 Angela Gregson Practice and Professional Development Lead Palliative and Continuing Care](https://reader033.vdocuments.mx/reader033/viewer/2022051401/56649e625503460f94b5ea25/html5/thumbnails/15.jpg)
Discussion
Any questions?