Health Promoting Palliative Care & Developing Compassionate Communities Understanding the drivers for and evidence supporting community development in health and social care. Understanding how this approach has been applied to end of life care. Learning about the Compassionate Cities Charter and how this may be implemented locally.

1. WELCOME
Tuesday 28 April 2015 Webinar
Health Promoting Palliative Care &
Developing Compassionate Communities

2. Health Promoting Palliative Care &
Developing Compassionate Communities
Tuesday 28 April2015
12.30pm – 1.30pm
Libby Sallnow, Palliative Medicine Doctor
Julian Abel, Palliative Care Consultant,
Weston Area Health Trust & Weston Hospicecare
&
Beverley Matthews
LTC Programme Lead, NHS Improving Quality

3. Bev Matthews
A nurse by background, Beverley has worked extensively throughout the NHS in a variety of clinical,
managerial and strategic roles. Beverley’s current role as Programme Delivery Lead for Long Term
Conditions Improvement Programmes: LTC Year of Care Commissioning Model and LTC Framework. Prior
to joining NHS Improving Quality in April 2013, Beverley was Director of NHS Kidney Care and NHS Liver
Care.
Passionate about service transformation through developing networks and leading complex
programmes. Providing strategic leadership to partners within health communities, managing stakeholders
and working across agencies.
Julian Abel, Palliative Care Consultant, Weston Area Health Trust & Weston Hospicecare
Areas of interest are compassionate community development in end of life care, electronic palliative care
coordination systems, widespread use of advance care planning, use of quality improvement methodology
in end of life care, and more recently development of a hospital treatment escalation plan. Contributed to
the National End of Life Strategy implementation, Transforming End of Life Care in Acute Hospitals and
currently working with the National End of Life Care Intelligence Network on developing end of life reports
that can be used for continuous quality improvement..
Libby Sallnow, Palliative Medicine Doctor
Undertaking a PhD in community engagement in end of life care. Research Fellow at St
Joseph’s Hospice, London. Doctoral student at the University of Edinburgh. Research
interests include a public health approach to end of life care, the role volunteers can play in
end of life care, benefits of collaboration for communities and hospices, developing new
models of engagement and compassionate communities. Libby has experience of working
with innovative programmes exploring these issues both in the UK and internationally and
has published books and articles on this field.
Meet the Speakers

4. Health Promoting Palliative Care &
Developing Compassionate Communities
• Understanding the drivers for and evidence supporting
community development in health and social care.
• Understanding how this approach has been applied to
end of life care.
• Learning about the Compassionate Cities Charter and
how this may be implemented locally.
of Care foundation.
Learning Outcomes

5. Beverley Matthews
LTC Programme Lead
NHS Improving Quality
Beverley.matthews@nhsiq.nhs.uk

6. LTC Year of Care
Commissioning Programme:
• 5 Early Implementer sites
• 35 Fast Followers
• Whole Population Datasets
• Implementation Guide
• Simulation Modelling
• Specialist Support Team

7. LTC Person Centred Care
Improvement Programme:
• 40 Early Implementer sites
• 4 regional learning networks
• Snapshot Survey
• Simulation Modelling
• Specialist Support Team

8. Long Term Conditions Learning Community
• LTC Dashboard
• Case Studies
• Lunch and Learn Series
• The Bulletin
• Specialist Support Team
@NHSIQ @bev_j_matthews #LTCimprovement #LTCyearofcare

9. To pre-register email LTC@nhsiq.nhs.uk
LTC Lunch & Learn Series
….coming soon…
Date Webinar Hosted by Bev Matthews &
29 April 2015
12:00 – 13:00
Information Sharing for Care Coordination Adam Hatherly, HSCIC
&
Christine Wike, NHSIQ
1 May 2015
12:30 – 13:30
Information as a Therapy Mark Duman
MRPharmS Director
Monmouth Partners
6 May 2015
12:30 – 13:30
Prevention & Effective Interventions in
Frailty
Helen Lyndon
Nurse Consultant Older People, Clinical
Lead Frailty, NHS England
27 May 2015
12:30 – 13:30
Primary Care Workforce for the 21
Century Webinar
Sharon Lee
Primary Care Workforce Facilitator
South Kent Coast CCG
4 June 2015
12.30 – 13.30
Home Checks/Prevention Peter O’Reilly & Geoff Harris
Manchester Fire & Rescue Service
9 June 2015
12 noon – 1pm
Health 1000 Rob Meaker
Barking, Havering & Redbridge

10. Community development in end
of life care
Libby Sallnow and Julian Abel

11. Why has community development
become the new buzz word?
Drivers for change:
• Recognition of limitations of professional knowledge
• Communities possess answers
• Demographic and funding pressures
• Appreciation of the impact of social factors on health
and wellbeing
• Top-down approaches often do not lead to sustainable
change
• Upstream interventions can have significant impact
• Health is everyone’s responsibility

12. The evidence base is now building
• Having a poor social network is as dangerous as smoking
15/day
– Social relationships and mortality risk: a meta-analytic review. Holt-Lunstad et al.
(2010) PLoS Med
• Having a strong social network in LTC results in significant
cost savings in formal care and improves mental and
physical wellbeing
– The contribution of social networks to the health and self management of patients with
long-term conditions. Reeve et al. (2014) PLOS One
• There is solid evidence that engaging communities has a
positive impact on health outcomes, behaviours, self-
efficacy etc.
– Community engagement to reduce inequalities in health: a systematic review, meta-
analysis and economic analysis. O’Mara-Eves et al. (2013) Public Health Research

13. Community development and end of
life care
• Kellehear first described the ‘public health
approach to end of life care’ (1999)
• Aligned the two apparently paradoxical
disciplines of EOLC and public health
Compassionate Communities are
community development initiatives that
actively involve citizens in their own end-of-
life care
Build partnerships between services and
communities to build on the strengths and
skills they possess, rather than replacing
them with professional care

14. Surge in interest in
the UK

15. Severn Hospice Community
Development Project
Reduced GP appointments. 44%
. Reduced A&E attendance. 30%
Reduce hospital admissions. 60%
Reduced Shropdoc calls. 30%
Reduced the cost associated with dependency. unquantified
Improved health and well-being for patients and
carers, initial evaluation
120%

16. Total Emergency Hospital admissions
0
2
4
6
8
10
12
14
16
18
6/12 prior how many emergency
admissions
6/12 post how many emergency
admissions
Series1
Total of Home visits
0
10
20
30
40
50
60
70
6/12 prior to coco how many home
visits?
6/12 post coco how many home visits?
Series1
Total A&E Attendances
0
1
2
3
4
5
6
7
8
9
6/12 prior to coco how many A&E
attendances
6/12 post coco how many A&E
attendances
Series1
Total visits to practice
105
110
115
120
125
130
135
6/12 prior to coco how many practices
visits?
6/12 post coco how many practices
visits?
Series1

17. What are the problems?
• Addiction to high cost professional services and failure
to imagine new ways of working
• Dying from a chronic illness, including frailty, is a
speeded up form of aging
• Main problems of people are loss of mobility, loss of a
role, loss of sense of meaning and value, with
increasing social isolation
• These problems cannot be addressed using
professional services alone
• The solution lies in supporting, enabling, encouraging
communities to look after and value their elderly, frail,
dying and those who are bereaved.

18. THE COMPASSIONATE CITY
- CHARTER -
Compassionate Cities are communities that
recognize that all natural cycles of sickness and
health, birth and death, and love and loss occur
everyday within the orbits of its institutions and
regular activities. A compassionate city is a
community that recognizes that care for one
another at times of crisis and loss is not simply a
task solely for health and social services but is
everyone’s responsibility.

19. THE COMPASSIONATE CITY
- CHARTER -
Compassionate Cities are communities that publicly
encourage, facilitate, supports and celebrates care for one
another during life’s most testing moments and experiences,
especially those pertaining to life-threatening and life-limiting
illness, chronic disability, frail ageing and dementia, grief and
bereavement, and the trials and burdens of long term care are
not the limits of our experience of fragility and vulnerability.
Though local government strives to maintain and strengthen
quality services for the most fragile and vulnerable in our
midst, serious personal crises of illness, dying, death and loss
may visit any us, at any time during the normal course our
lives. A compassionate city is a community that squarely
recognizes and addresses this social fact.

20. THE COMPASSIONATE CITY
- CHARTER -
 Our city will establish and review these targets and goals in the first two
years and thereafter will add one more sector annually to our action plans
for a compassionate city – e.g. hospitals, further & higher education,
charities, community & voluntary organizations, police & emergency
services, and so on.
This charterrepresents a commitment bythe cityto embrace a view of health and
wellbeing that embraces social empathy, reminding its inhabitants and all who
would view us from beyond its borders that ‘compassion’ means to embrace
mutualsharing.Acityisnotmerelyaplacetoworkandaccessservicesbutequally
aplacetoenjoysupportinthesafetyandprotectionofeachother’scompany,even
to the end of our days.