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NHS South Central makes end of life care a priority
Improving end of life care for patients and their carers is a strategic priority across NHS South of England (Central), and one in which it has already made a significant impact.
The eight PCTs and 14 CCGs which currently make up the South Central Strategic Health Authority take a highly structured approach to end of life care. These groups, which cover Berkshire, Buckinghamshire, Oxfordshire, Hampshire and the Isle of Wight, work together under the umbrella of the Regional End of Life Care Programme Board. Their approach is both holistic, with various bodies coming together to share best practice and ideas, and discrete, with each area running its own initiatives.
Lucy Sutton, Associate Director End of Life Care for NHS South of England (Central), says that this cross-team working coupled with the structured approach plays a key part in its success.
“While we share best practice and ideas when we meet, the PCTs and CCGs are all leading in different ways around their patch,” she said.
“The Calleva CCG end of life project, which is led by Charlotte Hutchings, used the Find Your 1% campaign as a framework to charge new integrated health and social care teams with finding their 1% as they were being set up.
“In Portsmouth, they are trialling a different approach. Currently 0.2% of people are on the end of life care registers, and they are aiming for 0.5% in the first instance."
Jonathan Price, the Portsmouth CCG end of life care lead, expands: “In the Portsmouth and SE Hants area as well as working with local GPs and Community nurses, hospital specialists, psychogeriatrians and the emerging CCGs to promote better and more EOL work, we are meeting with community groups to hear their views and encourage their members to learn more about advance care planning and the advantages it can bring.
"Once people understand the jargon and ultimate aims of the process they seem to welcome it enthusiastically as a common sense solution to improving the experience of people who are dying, and of their families and carers.
"Our experience supports the work done in the past that first suggested early identification, advance care planning and better communication via an EOL locality register are effective ways of facilitating more “good deaths”. Regular public engagement is essential in promoting this work – both to increase the public's expectations - we hope that more and more of them will demand the good service we are suggesting - and to keep our feet on the ground - keeping it all real.”
A new end of life care wishes toolkit has also been launched region-wide as a way to support and encourage people to start talking about how they would like to be cared for at the end of their lives. The Regional Advance Care Planning Toolkit contains guidance for the public, patients and carers, as well as NHS and social care staff. It aims to help people consider how they want to be cared for at the end of their lives and discuss this with their family and friends and the staff that care for them. The toolkit also directs health and social care professionals to training in initiating conversations about end of life care.
A further initiative, piloted in East Berkshire and the Isle of Wight, saw 1,400 recently bereaved relatives or carers being invited to contribute towards a confidential IMPROVE survey about their experiences of End of Life Care services. Following the pilot, the survey was rolled out nationally and the findings from the pilot work have been used to improve services locally. Lucy said that because the region had been working with QIPP on end of life care since early 2010, it was in a position to make rapid progress on the areas now covered by the National End of Life Care QIPP work-stream.