route to success - further resources
DESCRIPTION
This 'how to' guide builds upon the overarching framework set out in The route to success in end of life care - achieving quality in acute hospitals, published in 2010. The route to success highlighted best practice models developed by acute hospital Trusts, providing a comprehensive framework to enable hospitals to deliver high quality care to people at the end of life. This 'how to' guide aims to help clinicians, managers and directors implement The route to success more effectively, drawing on valuable learning from the NHS Institute for Innovation and Improvement's Productive Ward: Releasing time to care™ series. This guide contains individual sections that can be worked on in any given order, dependent upon the individual hospital and its current end of life care provisions. These can be downloaded below: Introduction Section 1: prepare Section 2: assess and diagnose Section 3: plan Section 4: treat Section 5: evaluate Section 6: sustain Section 7: further resources Cover It places emphasis on existing 'enabling' tools and models, which support and follow a person-centred pathway. These are Advance Care Planning, Electronic Palliative Care Co-ordination Systems (EPaCCS), AMBER Care Bundle, Rapid Discharge Home to Die Pathway, and the Liverpool Care Pathway. Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013TRANSCRIPT
Further resources
Section 7 The route to success
Section 7
The National End of Life Care Intelligence Network The network aims to improve the collection and analysis of information about end of life care services. This intelligence will help drive improvements in the quality and productivity of services.
The network’s website includes:
End of life care profiles – data and statistics on end of life within each local authority area broken down by age, gender, place of death and cause of death
Resources – data, reports, analysis and links to other useful sources of information
Data sources – a guide to key health, social care and related data sources in the field
Advice and information – signposting to advice and information for individuals, their relatives and carers.
www.endoflifecare-intelligence.org.uk
The End of Life Care Quality Assessment tool (ELCQuA) This is an online tool that has been updated recently and enables you to monitor how you are doing and compare your services with similar organisations locally and nationally. Progress can be assessed against a set of core specifications based on the Department of Health’s quality markers and measures for end of life care.
The ELCQuA website is intended for use by health and social care organisations providing and commissioning end of life care. The tool will enable you to:
Plan and monitor your priorities for end of life care
Assess your services in a local and national context
Share good practice with other organisations
Enable the best investment decisions for people at the end of life
Gather the information you need to complete Care Quality Commission and other assessments.
www.elcqua.nhs.uk
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e-ELCA The e-ELCA was commissioned by the Department of Health and aims to enhance the training and education of health and social care staff involved in delivering end of life care. It contains over 150 interactive sessions, which are free to access and focus on:
Advance care planning Assessment Communications skills Symptom management, comfort and well being
Social care Bereavement Spirituality
There is also an integrated learning module which covers specific settings and conditions.
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The route to success ‘how to’ guide
Blended learning pathways using e-ELCA have been developed and are being uploaded onto the NEoLCP website. They are;
Induction of Band 5 Nurses working in Specialist Palliative Care Services
GP Trainees on placement within Specialist Palliative Care Services
Ambulance Services Registered professionals working within acute hospitals
Clerical staff working in Palliative Care and End of Life Care Services
Out of Hours (OOHs) Urgent Care Practitioners
Volunteers within Palliative Care ServicesFeedback on using these to the e-ELCA team would be particularly useful
www.e-lfh.org.uk/projects/e-elca
Section 7
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Podcasts for end of life care facilitators The National End of Life Care Programme has developed a range of podcasts for facilitators to provide information on:
Managing conflict – how to prevent a conflict situation from spiralling out of control in order to improve chances of securing a positive outcome
Creating impact – the steps you need to feel at ease when meeting others, so you can make the most of the opportunities that arise and create the kind of impact you want
Different perspectives – provides the tools to see a situation from someone else’s perspective, ensuring you can create greater influence and avoid conflict
Listening to improve – one of the most important skills you have in your influence tool kit is listening, a key component of building rapport with people
Storytelling – the power of storytelling as a leadership tool and how to use stories to create indirect influence.
www.endoflifecare.nhs.uk/support-advice/facilitators-and-champions/podcasts.aspx
DNACPRThis web resource aims to explore issues around DNACPR but is not intended to be guidance or provide definitive answers. The range of speakers in the podcasts reflect different perspectives and it is hoped that the resource will encourage discussion and analysis of the complexities and different perspectives that surround existing guidance and legislation.
www.endoflifecare.nhs.uk/dnacpr
Transforming End of Life Care in Acute Hospitals PodcastThe Podcast describes the journey front line clinicians from some of the Acute Hospitals have undergone during the first year of participating in the Transform Programme and the difference they feel this has made to individual patient care at the end of life.
www.endoflifecare.nhs.uk/search-resources/multimedia/transform-programme.aspx
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The route to success ‘how to’ guide
NHS Change ModelThe model has been created to support the NHS to adopt a shared approach to leading change and transformation. The model brings together collective improvement knowledge and experience from across the NHS into eight key components and by applying all eight components change can happen.
www.changemodel.nhs.uk
Commissioning person centred end of life care – A toolkit for health and social careTo help achieve a ‘good death’ for all, the NEoLCP and its partners have produced a short interactive guide to commissioning person centred end of life care. It provides a wide range of links to tools and sources of support for both commissioners and providers of services and seeks to indicate what a well commissioned end of life care service looks like.
www.endoflifecare.nhs.uk/search-resources/resources-search/publications/commissioning-toolkit.aspx
Section 7
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Advance Care Planning: It all ADSE up ‘ADSE’ stands for Ask, Document, Share and Evaluate and this toolkit provides practical information on resources available to support the Advance Care Planning (ACP) process.
Within the toolkit there are challenges and top tips as well as links to other useful sources of information and guidance, aiming to enable care providers to approach the planning process with confidence and knowledge.
www.endoflifecare.nhs.uk/search-resources/resources-search/publications/acp-guide.aspx
The route to success series The series consists of National End of Life Care Programme publications that aim to provide practical support and guidance for health and social care professionals responsible for delivering end of life care. The publications cover:
Care homes (June 2010) Acute hospitals (June 2010) Hostels and homeless people (Dec 2010)
People with learning disabilities (Feb 2011)
Domiciliary care (Feb 2011) Occupational therapy (June 2011)
Nursing (July 2011) Environments of care (Aug 2011)
Prisons (Sept 2011) Ambulance services (Feb 2012).
Lesbian, gay, bisexual and transgender people (June 2012)
Social work (July 2012).
www.endoflifecare.nhs.uk/tools/core-tools/rtsresourcepage
The route to success ‘how to’ guide
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Section 7
www.endoflifecare.nhs.uk/tools/core-tools/rtsresourcepage
1. Directory of key contacts
2. Principles of good communication
3. Advance care planning
4. Advance decisions to refuse treatment
5. Quality markers for care homes
6. Dignity in end of life care
7. Models/tools of delivery
8. The dying process
9. What to do when someone dies
10. Flow chart for supportive care: Care home/sheltered housing
11. Quality markers for acute hospitals
12. Mental Capacity Act
13. Decisions made in a person’s best interests
14. Using the NHS Continuing Health Care fast track pathway tool
15. Enhancing the healing environment
16. Holistic assessment
17. Independent Mental Capacity Advocates
18. Preferred priorities for care
The route to success support sheets These are also available to help support the implementation of The route to success series. The 18 short summaries cover:
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The route to success ‘how to’ guide
Advanced kidney disease: www.endoflifecare.nhs.uk/
search-resources/resources-search/publications/imported-publications/end-of-life-care-in-advanced-kidney-disease.aspx
Dementia: www.endoflifecare.nhs.uk/
search-resources/resources-search/publications/imported-publications/care-towards-the-end-of-life-for-people-with-dementia.aspx
Disease specific end of life care resource guides and implementation frameworks are available covering a range of conditions:
Heart failure: www.endoflifecare.nhs.uk/
search-resources/resources-search/publications/imported-publications/end-of-life-care-in-heart-failure.aspx
Neurological disease: www.endoflifecare.nhs.uk/
search-resources/resources-search/publications/imported-publications/improving-end-of-life-care-in-neurological-disease.aspx
Section 7
A framework for social care at the end of lifewas developed by the National End of Life Care Programme with the involvement of a group of senior professionals and other stakeholders in social care. ‘Supporting people to live and die well’ sets out a direction of travel for social care at end of life.
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www.endoflifecare.nhs.uk/search-resources/resources-search/publications/imported-publications/supporting-people-to-live-and-die-well.aspx
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The National Audit Office end of life care report (2008) found that some people receive high quality end of life care, but that there is room for improved co-ordination between health and social care services in planning and delivery.
The route to success ‘how to’ guide
www.nao.org.uk/publications/0708/end_of_life_care.aspx
www.endoflifecare.nhs.uk
Published by the National End of Life Care Programme
ISBN: 978 1 908874 04 7Programme Ref: PB0005 A 02 12Publication date: Feb 2012 (updated Mar 2013)Review date: Feb 2014
© National End of Life Care Programme (2012)All rights reserved. For full Terms of Use please visit www.endoflifecare.nhs.uk or email
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Supported by the NHS Institute for Innovation and Improvement