The Health and Social Care Academy Integration Series

Palliative Care: from acute to the community

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Welcome

Lisa CurticePeople Powered Health and Wellbeing

(PPHW) Programme Director

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Panel Discussion• Policy and strategy relating to palliative care and how this

fits with integration – Mark Hazelwood, Chief Executive, Scottish Partnership for Palliative Care

• Service development in an integrated setting – Diana Hekerem, Marie Curie Divisional Business and Service Development Manager, Scotland

• How good palliative care can make a difference – Bill Whiland, Marie Curie Expert Voices Group

• Service on the ground – Caroline Paterson, Marie Curie Regional Manager Scotland (North)

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Photo

Photo - Highland Hospice

“Non-commercial provision of health care” – palliative care under Integrated Joint Boards.Diana Hekerem January 2016

Strategic Plans – Palliative Care

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“Who wants to live forever?”

Strategic Plans supporting commissioning of Palliative and End of Life CareMarie Curie formally recognised as a Non-Commercial Provider of Health Care.

Strategic Plans in general do not include:• Data to support commissioning e.g.

mortality rates, numbers with palliative care needs, admissions resulting in death

• Actions and services to address needs when “living well” is no longer possible

• Reference to hospice services and pathways

• Need to fast-track support for carers supporting patients with palliative and end of life care needs

• Recognition of dependency on voluntary sector for palliative and end of life care support

BUT• In Scotland, it is estimated that

around 40,000 of the 54,700 people who die each year need some palliative care

• With the number of people dying in Scotland due to increase by 13% over the next 25 years, this problem will get worse unless we act now.

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ONS (2014). 2012-based National Population Projections

Who are we talking to?

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Strangers in the Night…

“non-commercial providers”

Challenges

• Boards to HSCPs• 14 to 31• Health to social care• Increased number of organisations involved

in pathways

Benefits• Strong user voice• Volunteers• Community engagement and support• Subject matter expertise

Notes: further details here (or delete)Source: details here (or delete)

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Evidence Base?

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Nuffield and OPM studies

Source: OPM Evaluation Marie Curie Nursing Service. Dec 15

Source: Nuffield Trust: The impact of the Marie Curie Nursing Service on place of death and hospital use at the end of life 2014.

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Measuring Outcomes

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Integrated Care Fund - Evaluations

1: ? - Carers support2: Patients supported by community palliative care3: User feedback. Health Improvement Scotland and Care Inspectorate inspections4: User involvement5: LSE report on equity in palliative care6: Carers support7: Incidences & Inspections.8: Training, clinical governance9: Cost effectiveness of services; evidence impact of saving; use of fundraised income

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For more information contact:Diana Hekerem

Divisional Business and Service Development Manager

Marie Curie

Email: diana.hekerem@mariecurie.org.uk

Follow us on Twitter @mariecurieSCO

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How good palliative care can make a difference –

• Bill Whiland, Marie Curie Expert Voices Group

Marie Curie Nursing Service: delivering under integration.

Caroline Paterson, Regional Manager Scotland (North)SEN ,RN ,Dip Ed , BA Specialist Practitioner District Nursing , Advanced Nurse Prescriber

January 2016

Marie Curie in Scotland

Source: https://www.mariecurie.org.uk/help

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Services funded under Integration

Source: ICF Monitoring Returns

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Perth and Kinross Fast-track Service• Provision of Marie Curie

health and personal care assistants

• Working within DN and social care rapid response provision

• Collaborative working with social care teams

• “The fast track service has allowed our patients to be discharged from hospital in time to die at home allowing the patient there preferred place for end of life care.” DN

Falkirk Out of Hours Service• RNs based within Out of

Hours team in Forth Valley Royal

• Referrals through palliative care line

• 130 visits per month• 95% of patients

supported by the service died in their preferred place of care.

• 96% satisfaction rating from carers.

Glasgow Fast-track Discharge Service• Discharge Liaison

Nurses and senior health and personal care assistants

• Care to over 100 patients • KPIs include monitoring

potential bed day savings

• 80% discharge / 20 % admission prevention

Working more collaboratively

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Helper

Referrals from care homes, social care teams, DNs, hospitals, hospices patients, and carers.Awareness and collaboration with carers centres, community planning and other health charities

Hospices

Marie Curie – partnership with carers organisations, other hospices and health charities, schools & community groups

Other hospices – part of referral and support for “hospice at home” type care.

Training and Education

Working with care homes and social care teams on one day and on-line learning.

Engagement with range of palliative care educators

Working across systems

Argyll and Bute Service Delivering Choice and Local Clinical Coordination• Commissioned in 2012 to review

needs• 75% increase of people over 75 by

2037• Local clinical coordinated increased

access for remote rural and non-malignant

• Other projects included care homes, transport, health promoting palliative care and informal carers

The Lothian palliative care redesign programme aims to:· increase capabilities to identify patients and to plan care in anticipation, and in advance, ofneeds· improve coordination of care, within and across settings, to support patients and families withcomplex and unstable palliative and end-of-life care needs· increase community-based care service provision, and accelerate progress in shifting thebalance of end-of-life care towards greater community-based care· increase public awareness of, and community involvement in, the issues related to death,dying and bereavement

Notes: further details here (or delete)Source: details here (or delete)

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Caroline Paterson Regional Manager Scotland (North)Marie Curie

E mail caroline.paterson@mariecurie.org.uk

Mon – 07879 440108

Panel Discussion• Policy and strategy relating to palliative care and how this

fits with integration – Mark Hazelwood, Chief Executive, Scottish Partnership for Palliative Care

• Service development in an integrated setting – Diana Hekerem, Marie Curie Divisional Business and Service Development Manager, Scotland

• How good palliative care can make a difference – Bill Whiland, Marie Curie Expert Voices Group

• Service on the ground – Caroline Paterson, Marie Curie Regional Manager Scotland (North)

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Thank You!

www.academy.alliance-scotland.org.uk/academy@alliance-scotland.org.uk

@HandSCAcademy

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