• Evaluate the improved value that NHS 111 can provide to palliative care patients and their families by utilising specialist palliative care nurses within urgent and emergency care

      Bradley, Alison; Littlewood-Prince, Michela; Kaushal, Usha; Mitchell, Kathryn; Leyland, Claire; Wanstall, Judith; Cooper, Nicholas; NHS 111 (2016-09)
      Introduction NHS111 Yorkshire and Humber, using the 4C’s framework to review Concerns, Complaints, Compliments and Comments became aware of issues regarding ‘delays’ to care for palliative care patients. We conducted a systematic review of palliative care services to identify areas for improvement. Aims To improve the value that NHS111 could provide to palliative care patients by understanding pathways for palliative care, testing the use of specialist palliative resources, developing ideas for technology developments, enhancing access to medicines through the use of pharmacists and to understand how NHS111 can work to enhance out-of-hours palliative care services in the region. Methods Intelligence was gathered to identify the current position to support palliative patients. Interventions were designed to provide new and improved ways of working. Palliative Nurses were employed for 5-weeks during out-of-hours and training provided to the wider healthcare team. Results Analysis of the results allowed further improvements to the provision of 24-hour care and out-of-hours provision. Higher levels of demand were experienced during weekend hours and at the start of a Bank Holiday periods. Palliative Care Nurses were also able to provide high levels of self-care’ advice without requiring onward referral. Conclusions We directly identified empirical evidence and delivered a range of benefits which support the ‘Dying without Dignity’ report and provided recommendations to directly address the issues of poor symptom control, inadequate out of hour’s service and poor care planning. Furthermore Training and Development for NHS 111 staff in palliative care matters was further enhanced with the development of a palliative care e-learning package. https://spcare.bmj.com/content/6/3/406.1 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ http://dx.doi.org/10.1136/bmjspcare-2016-001204.57
    • Improving patient care - the Leeds dedicated palliative care ambulance service

      Borrill, Deborah; Colam-Ainsworth, Will (2014-03)
      Background Leeds have benefited from a bespoke palliative care ambulance service since 2007 when work done with Marie Curie and the “Delivering Choice” programme highlighted the need for the service. Early consultation with stakeholders identified that a lack of appropriate ambulance transport can be one of the factors that restricts or prevents the fulfilment of a patient’s previously expressed wish to die in the place of their choice. Aim The aim of the dedicated palliative care ambulance service is to provide flexible, prompt, safe and comfortable transport to patients moving to a place of their choice towards the end of life and to those needing palliative treatments and investigations. Method The Hospital Specialist Palliative Care Team, Leeds Commissioners, Yorkshire Ambulance Service (YAS) Leeds Hospices and Leeds Community Health worked closely together at a local level to improve the present palliative care ambulance service. Leeds commissioners have now funded a second ambulance to run on weekdays, covering the busiest times and new dedicated crews have been recruited and trained by the local hospice. Results This service will benefit patients, carers, healthcare professionals and healthcare providers by: Helping patients achieve their choice for place of care by reducing delays in discharge caused by restrictions to transport Ensuring appropriately trained ambulance personnel will provide quality care services to patients at the end of life during transportation Providing effective ways of working with professionals Providing better coordination and connectivity between hospital, hospice, community and ambulance services Conclusion In providing patients with choice in place of care at the end of life, whilst improving service provision, it is expected that the number of patients dying at home will increase. Future plans are to monitor present demand with a view to expanding the service further to support the transfer of palliative patients in Leeds. https://search.proquest.com/docview/1783985419/fulltextPDF/EBB9E264BEB34F77PQ/1?accountid=48092. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/bmjspcare-2014-000654.21