Award-winning initiative gives people the opportunity to shape their end of life care

Warrington CCG has landed a top prize in the Health Service Journal Awards for their work to improve end of life care with personal health budgets.

Winning the 2017 “Compassionate patient care” award, Warrington is one of five areas across the country now giving people more of a say in the care they receive in their last weeks and months of life. Personal health budgets are part of a range of work being led by NHS England to improve end of life care.

Hear patients, hospice staff and commissioners talk about the benefits of personal health budgets in Warrington in this short film:

Advertisements

Study shows dying at home more comfortable than hospital

Dying comfortably in very old age with or without dementia in different care settings – a representative “older old” population study | BMC Geriatrics | published online 5th  October 2017

A study from the University of Cambridge in the UK found that elderly people were four times more likely to die comfortably if their last days were spent at home or in a “care home”—defined to be either a residential care home or a nursing home—than if they were in a hospital.

Jane Fleming, a senior research associate at Cambridge, and colleagues, reported in BMC Geriatrics about their retrospective analysis of data from 180 deceased participants, ages 79-107 years. Relatives and caregivers were asked about the patients’ comfort level. The researchers learned only 10% of all participants died without pain or symptoms of distress.

Full document available at BMC Geriatrics

 

End of life care for homeless people

The Care Quality Commission and Faculty for Homeless and Inclusion Health have published A second class ending: exploring the barriers and championing outstanding end of life care for people who are homeless.

This report draws on research findings which explored the challenges to palliative care for homeless people in London.  It explores homeless peoples’ views and experiences of palliative care and aims to understand how they believe support could be improved.  It includes a series of case studies and recommendations.

second class

Image source: http://www.cqc.org.uk

Key discussion points

  • The needs of homeless people are not well understood or considered by health and care services. Where services do exist, they are often fragmented and work in relative isolation.
  • These issues are exacerbated by a lack of training and support for frontline staff.
  • Identifying homeless people who may be dying is difficult. Involving homeless people in decisions about their treatment and care means striking the right balance between supporting them and respecting their individual choices.
  • Actively linking health care, social care, housing and voluntary services may improve the care options available.
  • Working together will help continuity of care – this needs a collaborative effort across services.
  • There must be a strategic, equality-led approach at a local level, delivering personalised care. We share examples of excellent primary care and specialist community services.
  • Hospices and primary care organisations in particular can play a key role in championing an equality-led approach.

Additional link: CQC press release

The role of care homes in end of life care

The role of care homes in end of life care | National End of Life Care Intelligence Network |  Public Health England

care home

Image source: Brian Bullock – Flickr // CC BY 2.0

Public Health England’s National End of Life Care Intelligence Network has published two new data briefings, an infographic and a section of indicators on the End of Life Care profiles:

This briefing  presents data that describes the availability of residential and nursing home places together with the older population and the number of deaths.

This second briefing describes the recent trends in the demographics of people who receive end of life care in a care home.

An infographic summarising the key points from the two briefings can also be downloaded here

A new domain has been added to the end of Life Care profiles. These profiles can be used to explore local trends in this data, make comparisons with neighbours or regions and download maps and area profiles.

 

 

Talking about death

Age UK and the malnutrition taskforce have published a booklet and accompanying animation designed to help people have positive conversations about death with the people they care about.

Lets talk about death: How to have difficult conversations

 

Lesley Carter, Programme Head of Malnutrition Taskforce and Head of Health Influencing at Age UK said: ‘We know that having the confidence to start a conversation about dying and death is very hard, we struggle to find the right time, the right words and we are terrified of upsetting the other person and ourselves.

‘We have written this bright well-illustrated book and film that can be used to explore this issue with children, adults and professionals. We’ve explained why it is important to talk about dying and death, given ideas of how you could start a conversation, what you may want to say. Obviously, we are all different, you will find your own words. We hope that these resources will give you the confidence to give it a go.’

The booklet is available to download here

Choice in end of life care

How the National End of Life Care Programme Board is delivering personalisation and choice in care for people at or near the end of life. | Department of Health

forest-path-238887_1920.jpg

This report sets out the progress the National End of Life Care Programme Board has made in implementing the government’s choice commitment.

The measures include:

  • supporting the roll-out of digital palliative and end of life care records to all areas by 2020
  • inspecting and rating NHS hospital and community services for end of life care
  • providing support to trusts to help them improve end of life care services
  • testing personal health budgets for people approaching the end of life to give them choice and control over their care
  • developing metrics to assess quality and experience in end of life care
  • working to change the nursing and medical undergraduate and postgraduate curricula to improve patient choice and quality of care

Full report: One Year On: The Government Response to the Review of Choice in End of Life Care

Death and dying in the UK

Death, dying and devolution | The University of Bath Institute for Policy Research

cemetery-2650712_1920 (1).jpg

The articles in this collection cover what happens before someone dies, including issues around palliative care and support for carers; what happens at death, including issues around the proper regulation of funerals and public financial support for the bereaved; and what happens to those who are left behind, including emotional support for those who have been bereaved and issues around managing the estates of those who have died.

The report reviews policy areas associated with death, dying and bereavement within the context of devolution. It focuses on the national and regional delegation of power, resources and authority across the UK and the implications of this for those who are dying, dead, or bereaved as well as those tasked with organising and running the services that support these groups of people.

The report can be downloaded here