An alternative perspective from the third sector
•Download as PPTX, PDF•
1 like•276 views
On 20 January, 2017 Joanne Stradling, Divisional General Manager at Marie Curie, spoke at Transforming end of life care in acute hospitals. Joanne spoke on different models for end of life care, benefits to patients, cost effectiveness of home care and the lessons from integrated systems.
Recommended
Recommended
More Related Content
What's hot
What's hot (20)
Viewers also liked
Viewers also liked (17)
Similar to An alternative perspective from the third sector
Similar to An alternative perspective from the third sector (20)
More from Marie Curie
More from Marie Curie (11)
Recently uploaded
Recently uploaded (20)
An alternative perspective from the third sector
- 1. An Alternative Perspective from the third sector Jo Stradling Divisional General Manager, Central & Eastern England
- 2. An Alternative Perspective from the third sector 2 • Different models for end of life care • Cost effectiveness of home care • Benefits to Patients • Lessons from Integrated Systems
- 3. Current Position 3 47% of deaths take place in hospital 30% of bed occupancy in last year of life Number of deaths due to rise 17% by 2030 Basic demand pressures will not change demography and morbidity… but we can change the supply factorsBest systems in UK
- 4. International Perspective… 4 % of deaths taking place in hospital: New Zealand 28.1% Context: • System • Funding mechanisms • Societies attitude to death • Qualified workforce • Palliative care is free • Universal access • Low percentage of deaths taking place in hospital Netherlands 24.6%
- 5. Kinds Fund Study on the Sustainability of Social Care Services 5 Key findings from: Social Care and Older People – The Home Truths • Social Care system in its current form is struggling to meet the needs of older people • Huge pressures on the social care market • Access to care depends increasingly on what people can afford- and where they live – rather than on what they need • There is a widening gap between needs and resources set to reach at least £2.8 billion by 2019 Three major strategic challenges: • Achieving more with less • A different offer • Long-term reform https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Social_care_older_people_Kings_Fund_Sep_2016.pdf
- 6. Deaths in hospitals are an unnecessary burden on our struggling healthcare system Huffington Post article by Dr Jane Collins http://www.huffingtonpost.co.uk/dr-jane-collins/nhs-crisis-marie-curie_b_14145006.html Care and support needs of those who are dying in UK, are being fundamentally neglected Care packages are not put in place in time for hospital discharge Need to recognise the role of social care at end of life Ironically, these failures in terms of transferring care often mean that the NHS will spend more money on costly hospital treatment. Also, more cost effective to die at home and mostly personal preferences 6
- 7. 7 Simply doing more of the same is not sustainable!
- 8. Exploring the cost of care at the end of life Nuffield trust research report 2014 http://www.nuffieldtrust.org.uk/sites/files/nuffield/publication/end_of_life_care.pdf8 Two thirds of patients saw their GP at least once during last three months of life 40-50 minutes of district nurse time per day in last few days of life. Just over a quarter of people used local authority funded social care in final year of life Hospice costs est £550 per person Hospital cost for final three months of life = £4500 per person Hospital costs are highest
- 9. Community Alternatives 9 Primary Care District Nursing Social Care Home Care Increased complexity of provision Drivers and incentives not aligned Community
- 10. Benefits to patients through successful commissioning Personalised care planning Coordinated care and support including information Rapid access to specialist advice Services that treat people as individuals, and with dignity and respect Services that acknowledge patient and carers as part of the care team Equality of access Experience of services of a consistent high quality PATIENT CHOICE
- 11. Exploring the cost of care at the end of life Nuffield trust research report 2014 continued… People who received care from our Marie Curie Nursing service… ….had a lower average hospital costs of £1140 per person. …spent two and half fewer days in hospital during last 90 days of life. …were less likely to need emergency hospital care (12% vs. 35%) … were less likely to die in hospital (8% vs. 42%) 11
- 12. Community Nursing – rethought 12 Overnight Service Rapid Response Companionship Helper
- 13. Hospices – Rethought 13 Inpatients Outpatients One Stop Shop / Holistic Care / Different Environment Day Therapy Rehabilitation Integrated Provider
- 14. Contact details Website: https://www.mariecurie.org.uk/ Information and support line: 0800 090 2309
- 15. Questions?
Editor's Notes
- But we can change the supply factors
- New Zealand & the Netherlands: both have excellent facilities, qualified workforce, access to palliative care is free and universal. Good system = low % of deaths taking place in hospital https://www.eiseverywhere.com/file_uploads/37856d137d4a0aae37c05ec7ddfb1282_Plenary1.pdf https://www.eiuperspectives.economist.com/sites/default/files/images/2015%20Quality%20of%20Death%20Index%20Country%20Profiles_Oct%206%20FINAL.pdf Differences in EOL care internationally, in the UK we need to find a sustainable model that suits our population.
- http://links.precise-media.co.uk/OpenVideo.aspx?ArticleID=335878370&AgreementID=132957&ClientID=38557 http://www.huffingtonpost.co.uk/dr-jane-collins/nhs-crisis-marie-curie_b_14145006.html
- Info GP visits: Average 4-5 GP visits per person in last 3 months of life (rates much higher for cancer patients) District nurses 1/3 patients had contact with a district nurse in their last 90 days- average cost per person was not high £278- A clear increase in activity in final days of life. Most intensive 10% of users average 40-50 minutes of district nurse time per day in last few days of life. Local Authority Just over ¼ of people used local authority funded social care in final year of life. Average cost over last three months = over £1000 for nursing and residential care + higher costs for older age groups Hospice: Average total inpatient hospice cost £400 (Based on £400 per day x 14 day stay = £5600, averaged over all people who have died) Hospital cost is largest- care in final three months =£4500 per person- bulk due to emergency hospital admissions. Hospital costs are largest costs involved in EOL care. Hospital costs increase for each condition a person has, while the same is not true of social care costs
- https://www.kingsfund.org.uk/sites/files/kf/Delivering-better-care-end-of-life-Kings-Fund-January-2010-Leeds-Castle-EOLC.pdf
- Potential savings from reduced hospital care for people who are able to access community care services. Using Marie Curie nursing service as an example- estimated if hospital activity and costs at the EOL were likely to be offset by increased care costs in other health and social care sectors. – care costs very likely to be lower at about £500 per person even allowed for the commissioning costs of home based nursing support at the EOL.