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www.england.nhs.uk
Working Together to Transform End
of Life Care in Acute Hospitals
Central Hall Westminster
18th November 2015
www.england.nhs.uk
Working together
to transform end
of life care in
acute hospitals
Prof Bee Wee
NCD for End of Life Care
18th November 2015
www.england.nhs.uk
Wider context
New models of care – range of vanguards
NHS England Business Plan priorities
Initiatives for improving:
integration
personalised care and control
Support for improvements:
organisation level
System level
www.england.nhs.uk
www.england.nhs.uk
www.england.nhs.uk21/12/2015
www.england.nhs.uk21/12/2015
www.england.nhs.uk21/12/2015
www.england.nhs.uk21/12/2015
www.england.nhs.uk21/12/2015
www.england.nhs.uk21/12/2015
www.england.nhs.uk
Acute hospitals
• ‘Transform’ Programme:
• 5 core enablers
• What next?
• National audit – care of the dying adult
• CQC – end of life care theme
21/12/2015
www.england.nhs.uk
Metrics
• Place of death
• Extent to which preference met: place of death, place of
care, other preferences
• Experience of care: patient, carer (current), carer (recall),
staff
• Other measures
• Time spent in hospital / out of hospital
• Number of unscheduled admissions
• Investigations in last week of life?
• Others?
www.england.nhs.uk
Data and information
• National EoLC Intelligence Network
• National survey of bereaved people: VOICES-SF
• National audit of dying in hospital
• Reversal in trend of increasing proportion of deaths
taking place in hospitals
• Economic Intelligence Unit – UK ranked top
www.england.nhs.uk
National Survey of Bereaved People
(VOICES-SF)
• 75% rated overall quality of care as outstanding, excellent
or good
• 10% rated care as poor
• 69% of deaths in hospital rated as outstanding, excellent
or good
• 79% at home; 82% in care homes; 83% in hospices
• 33% perceived hospital services not working well with GP
and other out-of-hospital services
www.england.nhs.uk
National Survey of Bereaved People
(VOICES-SF): inequities
• 49% of deaths due to cancer – reported to have
outstanding/excellent care:
• 39% - from cardiovascular disease
• 40% - from other diseases
• Those living in most deprived areas had more reports
of care being fair/poor: 30% vs 21%
www.england.nhs.uk
‘How to’…..
• Learning from everybody’s
insights
• Learning from each other
• ‘Buddies and peers’
• Route to success:
‘How to’ guide
www.england.nhs.uk
Dual task for hospitals
• Improve care for people in acute hospitals
• Improve integration and handover with community-
based services and other hospitals
21/12/2015
www.england.nhs.uk
Improving Quality in End of Life Care in
Acute Hospitals
Core enablers
‘Building on
the Best’
(Macmillan/
NCPC)
www.england.nhs.uk

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