'Palliative and End of Life Care in the UK' - HFH Conference 2016 Keynote Address by Prof. Bee Wee (Presentation at HFH 2016 Conference)
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'Palliative and End of Life Care in the UK' - HFH Conference 2016 Keynote Address by Prof. Bee Wee (Presentation at HFH 2016 Conference)
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'Palliative and End of Life Care in the UK' - HFH Conference 2016 Keynote Address by Prof. Bee Wee (Presentation at HFH 2016 Conference)
- 1. Compassionate Care at End of Life in Hospitals: Hospice Friendly Hospitals Conference: April 2016 Palliative and end of life care in the UK Professor Bee Wee National Clinical Director for End of Life Care, NHS England Consultant in Palliative Medicine, Oxford, UK
- 2. www.england.nhs.uk Context: NHS and social care Palliative and End of Life Care Focus on hospitals Reflections and lessons
- 3. www.england.nhs.uk DHParliament 10 Strategic Health Authorities 152 Primary Care Trusts CQC 3 NHS Trusts NHS Foundation trusts Monitor NHS TDA National improvement bodies, e.g. NEoLCP
- 5. www.england.nhs.uk • Health and wellbeing gap • Care and quality gap • Finance and efficiency gap
- 7. www.england.nhs.uk National End of Life Care Strategy 2008: ‘End of Life Care Pathway’ Step 2 Assessment, care planning and review Step 3 Coordination of care Step 4 Delivery of high quality services in different settings Step 5 Care in the last days of life Step 6 Care after death Discussions as the end of life approaches Step 1 Social care Spiritual care services Support for carers and families Information for patients and carers
- 8. www.england.nhs.uk The year of 2013 • Francis Report – Mid Staffs (Feb) • Health and Social Care Act (April) • Neuberger Report – Liverpool Care Pathway (July) 18/05/2016
- 18. www.england.nhs.uk ‘Transform Programme’ • Core enablers • Advance care planning • Electronic palliative care coordinating systems • Rapid discharge to home • AMBER care bundle • Care in last days of life • Quality improvement methodology • Central teams to support implementation
- 19. www.england.nhs.uk Programme Oversight Board Transforming EoLC in hospitals
- 20. www.england.nhs.uk Patient and Family Centred Care Select a care experience Establish a guiding council Evaluate current situation – through eyes of patients and families Develop PFCC care experience working group Creating shared vision through written ‘ideal experience’ Identify PFCC improvement projects and form project improvement teams http://www.kingsfund.org.uk/projects/pfcc https://www.pointofcarefoundation.org.uk/our-work/patient-family-centred-care/
- 21. www.england.nhs.uk Prods Proactive support Speed up improvem ents People focused Adapted from: Allcock et al Constructive comfort: accelerating change in the NHS Health Foundation, Feb 2015 CQC Inspection National audit Incentives Improvement strategy & support Sharing ‘best’ practice Buddies and peer systems Education & training CPD Contracts & welfare
- 22. www.england.nhs.uk Reflections and lessons • Terminology – semantics and unintended consequences • Specialist palliative care teams and generalist teams – roles different but interdependent • Risks of over simplistic reliance on tick boxes: provides a ‘cloak’ for whom? • Need to understand what is artefact and what is beneath the surface of any experience or intervention • Measuring what really matters not just what’s measurable