Marie Curie and providers around north Glasgow and Lothian launched two fast track discharge services for palliative care that have benefitted up to 500 patients, significantly improving their end of life care

Elderly in man in bed with health worker tending to him

Most people would like to remain at home in familiar surroundings to receive their care at the end of life

This article was part of the End of Life Care channel, in association with Marie Curie Cancer Care. The channel is no longer being updated.

In 2012, two fast track discharge services in north Glasgow and Lothian were launched for people receiving end of life care.

The two services, launched by Marie Curie, NHS Greater Glasgow and Clyde, and local providers, have since benefitted almost 500 people and have significantly improved end of life care in both areas.

‘The focus has been on improving the transfer of people from a hospice or hospital into their preferred place of care’

The services, run in partnership with Marie Curie Cancer Care, were launched to align end of life care services with Scotland’s national action plan for palliative care, Living and Dying Well: Building on Progress, in 2010.

The aim has been to:

  • provide quality, coordinated care;
  • support carers at times of crisis; and
  • follow a best practice model that could be easily replicated.

For Lothian, in particular, it was important that services supported people with a non-cancer diagnosis in a community setting. For both, however, the focus has been on improving the transfer of people from a hospice or hospital into their preferred place of care.

Avoidable admissions

Both discharge services have been successful in supporting safe discharge and palliative care in the home.

The service in Glasgow, funded by the Reshaping Care for Older People change fund, allowed 210 patients to be safely discharged in 2013-12 and prevented 99 patients from being admitted to a hospice or hospital.

‘This has improved patient and family experience by providing emotional support’

Marie Curie supports the service in north Glasgow by providing fast track liaison nurses who assess a patient’s care needs and organise support for the patient immediately after discharge.

The service also takes referrals to prevent avoidable hospital or hospice admissions. This has since reduced the time patients have to spend in hospital and has also improved patient and family experience by providing emotional support at a stressful time.

Reducing acute stays

Lorna Dunipace, head of primary care services at Glasgow Community Health Partnership, comments that the “fast track service supports patients and families with palliative care needs in their own home by providing a service that meets both their health and social care needs”.

“People at the end of life, who wish to die at home, are enabled to do so, thereby reducing length of stay in acute beds,” she adds.

‘Patients are now able to spend more time with their loved ones in their own homes’

The Lothian service works in a very similar way to Glasgow. However, it is also able to support care at home for up to seven days after discharge.

Of the 188 patients supported by this service, the deaths of 137 were recorded. The data showed 80 per cent had died at home, while only 6 per cent died in hospital.

A recent patient and carer survey carried out in Lothian also revealed that patients are now able to spend more time with their loved ones in their own homes.

One carer, whose sister received care in 2012, commented that the service made her feel “supported and cared for” and offered “the highest quality of care at the most difficult of times”.

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