Improving End of Life Care

TDA WorkshopWednesday 18 November

14:00 – 15:00

Welcome and Introduction

Peter Blythin

Purpose of Workshop 

Development and Support to enhance the quality of end of life care

Share improvement proposal based on Transform Programme

Understand your initial requirements for support 

AgendaTime Topic Speaker

14:00 Welcome Peter BlythinDirector of Nursing, NTDA

14:05Advance Care Planningprocess here at Brighton and Sussex University Hospital

David Howlett, Foundation Year 1 DoctorDilan Joshi, Medical StudentSarah French, Theatre SisterSherree Fagge, Chief NurseBrighton and Sussex University Hospital

14:20 Improvement Support

Jacquie  McKennaDeputy Director of Nursing, TDADaljit AthwalNursing Fellow, TDAMaggie Morgan‐CookeLong Term Conditions, NHS IQ

14:55 Next StepsJacquie  McKennaDeputy Director of Nursing, TDA

Advance Care Planning

process here at BSUH

Transforming End of Life Care in

Acute Hospitals Conference

18 November 2015

David Howlett Foundation Year 1 Doctor

Dilan Joshi Medical Student

Sarah French Theatre Sister

Sherree Fagge Chief Nurse

The Route to

success in end of

life care –

achieving quality in

acute hospitals

Transforming End

of Life Care in

Acute Hospitals

Five key enablers

1. Advance Care Planning process

2. ShareMyCare our Electronic Palliative

Care Coordination System (EPaCCS)

3. AMBER care bundle

4. Rapid Discharge Pathway for the dying

patient who would like to die at home

5. The Priorities of Care of the Dying Person

What are we doing?

Major focus at BSUH

for all staff on a

personal and professional level

Advance Care Planning

process

I didn’t want that video

(Dying Matters 2012)

Dying Matters Coilition

Advance Care Planning in Kent,

Surrey and Sussex:

A Report and Recommendations

from the South East Coast Clinical

Senate

Five key enablers

1. Advance Care Planning process

2. ShareMyCare our Electronic Palliative

Care Coordination System (EPaCCS)

3. AMBER care bundle

4. Rapid Discharge Pathway for the dying

patient who would like to die at home

5. The Priorities of Care of the Dying Person

• Engagement & Networking

– End of Life Care Links for all clinical areas

• Education

– End of Life Care Education Series

– End of Life Care Study Days

– End of Life Care Link Workshops

– End of Life Care Newsletter

– End of Life Care Intranet Site

– End of Life Care Conference

Sharing wishes and

preferences

Starts with YOU!

YOU?

Context• Identified Trusts assessed as inadequate or 

requires improvement• Key national imperative• TDA working in collaboration with NHS England, 

The National Council for Palliative Care and Macmillan

• Part of CQC eight core services inspected

CQC reports – positive themes• Caring and compassionate staff• Specialist team working 

relationships• Communication with relatives 

and patients

CQC reports – improvement themes

• Documentation – DNA CPR forms and personalised care plans• Leadership and strategy• Mental Capacity – assessments, DNA CPR, staff knowledge• EoLC Training• National guidance – post LPC• Identifying EoLC patients• Lack of measures re care and experience• Staffing levels –impacting opportunities• Incident reporting – inconsistencies, learning• Discharge of EoLC patients

The six ambitions for palliative and end of life care

1. Each person is seen as an individualI, and the people important to me, have opportunities to have honest, informed and timely conversations and to know that I might die soon. I am asked what matters most to me. Those who care for me know that and work with me to do what’s possible.2. Maximising comfort and wellbeingMy care is regularly reviewed and every effort is made for me to have the support, care and treatment that might be needed to help me to be as comfortable and as free from distress as possible3. Each person gets fair access to careI live in a society where I get good end of life care regardless of who I am,    where I live or the circumstances of my life.

The six ambitions for palliative and end of life care

4. Care is coordinatedI get the right help at the right time from the right people. I have a team around me who know my needs and my plans and work together to help me achieve them. I can always reach someone who will listen and respond at any time of the day or night.5. All staff are prepared to careWherever I am, health and care staff bring empathy, skills and expertise and give me competent, confident and compassionate care.6. Each community is prepared to helpI live in a community where everybody recognises that we all have a role to play in supporting each other in times of crisis and loss. People are ready, willing and confident to have conversations about living and dying well and to support each other in emotional and practical ways

What support do you needConsider following 3 areas:1. What are the barriers you are facing which 

get in the way of delivering high quality End of Life Care?

2. Where there is good practice in your Trust, what supports/facilitates this?

3. Where/what support do you need to improve?

Supporting You ‐ Plan• Year Long Improvement Programme – Transform• Rough timescales

‐ November 2015 to January 2016 – Diagnostics to understand Trust requirements

‐ February 2016 to March 2016 – Improvement Agreements‐ April 2016 to November 2016 – Implement and Evaluate

• Monthly telecon• Learning Webex Events• Trust Visits

Thank youAnything else?