2 Learning from a new model of end of life care for older people with frailty/multi-morbidities – the challenges and opportunities for specialist palliative care services. Issue 3 (1st September 2018)

• Record Type: Journal Article
• Authors: Noble, Jan; Nicholson, Caroline; Harris, Laura; Richardson, Heather
• Is Part Of: BMJ supportive & palliative care. Volume 8:Issue 3(2018)
• Page Start: 360
• Page End: 360
• Publication Date: 2018-09-01
• Subjects: Palliative treatment -- Periodicals; Terminal care -- Periodicals; 616.029
• DOI: 10.1136/bmjspcare-2018-mariecurie.2
• Languages: English
• ISSNs: 2045-435X

Abstract

Abstract : Introduction: Bromley Care Coordination (BCC) at St Christopher's Hospice is an innovative nurse-led community based service to enable patients with advanced illness or frailty thought to be in the last year of life to receive timely and well- coordinated care at home. Commissioned in 2014 by Bromley CCG reaches people who would not traditionally be seen by hospice community care teams. The Bromley Care Coordination Centre offers 24/7 telephone support and home visits to patients providing symptom control pain control and psychological support. Aim: To understand patient characteristics end of life needs and BCC service response in order to refine service delivery. Methods: Service evaluation using routine collected service data notes and case reviews. Results: Results since Jan 2014: 2200 people have been referred (55% from GP 26% from Hospital 19% other) Of those who have died 70% have died in their own home/care home Average age of patients referred 86 The ratio of non-cancer to cancer diagnoses is 85%: 15% 86% of patients have no other current health care intervention apart from the GP and occasionally a social care agency/provider (16/17 data) 39% of patients live alone many more patients live with a spouse who is also frail and elderly. Conclusions: Learning has led to working with a different skill mix developing a 'stratification' tool introducing the role of care navigators and volunteers. BCC has extended the hospice's reach by 50% in one CCG. The next stages are embedding sustainability and implementation in other areas.