The key to improved end of life care

A healthcare system designed to meet the needs of previous generations is facing unprecedented pressure from advances in medicine, an ageing population and an increase in those living with long term conditions and complex care needs. If the NHS is to continue to meet patient needs now, and in the future, then radical change to historic ways of providing and using healthcare is essential.

‘Partnerships can offer patients a greater chance of ending their life in the place of their choice’

Partnership working is part of this radical change and holds the key to unlocking innovative approaches and efficient care. Partnering with the voluntary sector offers clear benefits, for example around shifting care and support into a community setting, accessing extensive local expertise and plugging gaps in existing services.

This is particularly relevant for areas such as end of life care. Partnerships can offer patients a greater chance of dying in the place of their choice – increasingly that means at home, but sometimes it is undoubtedly better for some people to be cared for in a hospice setting. Partnership working can also reduce avoidable end of life activity in increasingly pressurised acute hospital services.

Across the UK, there are strong examples of charities working in partnership with the NHS to deliver high quality, joined up care to patients.

In Durham and Darlington, for example, the NHS and voluntary sector are working well in partnership to deliver expert palliative and end of life care at short notice to patients at home.

Karen Torley, Marie Curie’s divisional general manager for the North East, says: “High numbers of patients were being admitted to hospital at the end of life and dying within eight days of admission. There was also a lack of capacity in the local community team to support patients at short notice.”

First for the North East

Launched in 2012, the partnership is the first of its kind in the North East. It brings together expertise and resources from Marie Curie, local independent hospices and the local NHS foundation trust. Between December 2012 and May 2013, there were no hospital deaths for patients seen by the service – 79 per cent died at home, 20 per cent in a nursing home and 1 per cent in a hospice.

The partnership is a strong demonstration of how, working together, the voluntary sector and NHS can prevent unnecessary hospital admissions and achieve better outcomes for patients.”

‘We’ve only had glowing references from families so we know there is a lot of good work being done to help people stay at home’

“Information about the service from partner hospices St Teresa’s and St Cuthbert’s is that family feedback is positive,” says Darren Archer, former senior manager – provider management, North of England Commissioning Support. “We’ve only had glowing references from families so we know there is a lot of good work being done to help people stay at home.”

Getting local partnerships like this right, and learning from them, can potentially deliver longer term, large scale benefits for the NHS and patients alike.

Dr Peter Nightingale is national clinical lead for end of life care for the Royal College of GPs and Marie Curie Cancer Care