by Laura Dobie, Knowledge and Information Skills Specialist In December 2017 some of our team went to Oban to learn about how partnership working and a focus on prevention and early intervention is having a… More
Ask Glaswegians about palliative care and many would pay testament to the superb specialist hospices and palliative services within the city, and the care and support received at the end of a loved one’s life.
There are also a host of community staff; dedicated, experienced individuals working along-side specialist services to support the palliative and end of life needs of its population.
But palliative care is not just required at end of life. Many Glaswegians are living with long-term, life-limiting conditions which require on-going care and support within their own home.
Life expectancy in Glasgow is lower than the national average.
You are more likely to die from cancer, smoking-related diseases, heart disease or be hospitalised with COPD.
It’s vital we do all we can to identify those who would benefit from palliative care and ensure that support is available to allow them to live and die well.
My role is to support the testing of ways to improve how we do this, and help share the story of that improvement with others.
With support from Healthcare Improvement Scotland, I hope to work with colleagues and partners to evidence an improvement in identification of palliative care need and care co-ordination.
Glasgow has the largest care home population of any local authority in Scotland and some of the improvement work will focus on the residents of these homes.
The needs of this population are complex. Finding ways of listening to their preferences and supporting them to receive care in what for them is their home may be a challenge, but a worthwhile one.
I believe that improving identification of their needs and wishes, monitoring and planning for change and improving communication with the wider care team will support us to provide person-centred care in the correct setting.
Although care homes are a focus I would welcome any thoughts or ideas for improving identification or care co-ordination for any care group within the community. Please get in touch.
by Ian Mountford, Communications Executive, Energy Saving Trust
The ihub Frailty and Falls Assessment and Intervention tool highlights a fuel poverty check as a key consideration when determining if someone is in a safe and suitable environment. Individuals experiencing fuel poverty often find it difficult to heat their home, and are worried about their fuel bills.
If you have identified an individual who needs support, a good place to start is by speaking to Home Energy Scotland. Funded by the Scottish Government and delivered by the Energy Saving Trust, their network provides free, impartial advice to help older people with frailty to:
- save energy;
- reduce heating costs;
- access nationwide or local energy efficiency schemes;
- maximise their income; and
- identify and access any support available from their energy supplier.
Some households have saved £1,000 a year, and others have qualified for free heating and insulation.
Home Energy Scotland welcome referrals and partner with a number of organisations that make use of their easy-to-use online referral portal, where clients can be securely referred and useful feedback can be obtained on referral outcomes. More information on the referral portal can be found in this short video.
Their trained advisors are located in five centres across Scotland, and give advice over the phone or in person. In addition, their community liaison teams support partner organisations with a range of advice and resources.
HES Homecare Pilot
Householders in the Moray East and Annandale and Eskdale health and social care partnership areas can benefit from extra help through a pilot project called HES Homecare. HES Homecare Energycarers visit people whose health makes them vulnerable to cold-related illness, and work with Care and Repair and Warmworks to make those homes easier – and cheaper – to heat. Contact HESHomecare@est.org.uk for more information.
To find out more about how Home Energy Scotland can support older people experiencing fuel poverty, you can visit their website, contact Mark Macleod, Stakeholder Relations Officer, on 0131 555 9151 or email HES_Partnerships@est.org.uk.
First of all I would like to say thank you to all the people who have got in touch with me in this new role as nursing national clinical lead for palliative care at Healthcare Improvement Scotland. Having conversations with like-minded colleagues is just great and, to me, the first step in working towards change and improvement. I am hoping that by engaging with as many teams as possible, I can learn about any particular issues and share best practice – please tell me about any good work going on, too! In providing palliative and end of life care we all have a common goal of getting it right for patients and those important to them at what can be a most difficult time, and we only get one chance to get it right.
In addition to working with six test sites in an advisory capacity, teams I have met to date include leads in NHS 24, Scottish Ambulance Service (SAS), Children’s Nurses, and Care Opinion, as well as teams within HIS and Scottish Government. All these conversations are about how we can ensure dignity at the end of life every time, such as through reducing the risk of inappropriate resuscitation attempts. Not surprisingly, it always comes back to the need for sensitive conversations earlier on in someone’s journey! It is essential that we support staff and teams to be able to have these conversations, which can be highly complex.
In July I attended a session at University College London Hospital recently on Talking DNACPR, and it was excellent. One thing I learned was the 5Ps model for sharing difficult information, based on work in St Christopher’s Hospice. Below is my adapted version:
P Purpose what is the purpose of this interaction?
P People who should be there? The patient/family? Should I take a colleague?
P Preparation what do I need to know?
P Process how will I construct the conversation – should I use a model, e.g. SPIKES?
P Product what is the outcome I expect? E.g. a completed Anticipatory Care Plan or DNACPR form?
I think this could be used as a simple approach when teaching staff.
Spotlight on the Four Principles
I mentioned the four principles from Caring for People in the Last Days and Hours of Life in my last blog post, and HIS have very kindly produced small cards that staff have can have in their pockets or use for teaching students, etc.
Please see below:
If you would like some, please contact: email@example.com.
Compliance with these principles will also ensure excellent delivery of the fundamentals of nursing as advocated in the Nursing and Midwifery Council Code.
Paul Baughan and Michelle Church, Improvement Advisor, with the Living Well in Communities poster at the conference
by Paul Baughan, GP and National Clinical Lead for Palliative and End of Life Care, Healthcare Improvement Scotland
For some people, the Scottish Partnership for Palliative Care conference is an annual pilgrimage, resembling a school reunion where people involved in palliative care can come together and catch up with one another (whilst secretly hoping that they have not aged as much as that colleague from the north or west of Scotland that they have not seen for a couple of years!). The informal sharing of experiences, pressures and local initiatives is every bit as important as the diverse programme.
My aims for the day
I attended this year’s conference with a specific question about how I could use the learning to support our six palliative care test sites. As joint clinical lead for palliative and end of life care with Healthcare Improvement Scotland, I am working with six health and social care partnerships (HSCPs) to support local improvement work around the early identification of those with palliative care needs and the co-ordination of their care.
We had the opportunity at the conference to display and discuss our poster, which outlines the approach and process which the test sites will undertake during their improvement work. There was great interest from the delegates regarding this work, which made me even more determined to use and apply learning from the day. Continue reading “My Perspective on the SPPC Annual Conference”
Our recent poster, displayed at the Scottish Partnership for Palliative Care annual conference, provides an update on where we are with our palliative and end of life care work.
Some members of the Living Well in Communities and Midlock teams at the NHSScotland event
The Living Well in Communities team is working with Health and Social Care Partnerships in Glasgow City, West Dunbartonshire and Midlothian to test the electronic frailty index (eFI) to identify people over 65 who are living with frailty in the community. The Living Well in Communities team have developed an assets-based approach to support evidence-based interventions that are tailored to the individual. This article looks at the work to date with Midlock GP practice in Glasgow.
The testing in Midlock GP practice
The eFI uses GP read codes to calculate an individual’s degree of frailty and stratifies them into fit, mildly frail, moderately frail and severely frail. The tool has been validated in England. The purpose of testing at Midlock GP practice was to determine if the tool was accurate in a Scottish context. We have been working with a GP and other members of Glasgow City HSCP, including housing and the voluntary sector. The testing involved stratification of the GP population for frailty and reviewing case scenarios to determine if the eFI tool fits with a Scottish population. Continue reading “Testing the eFI in Scotland: focus on Midlock GP practice”
On 27th June we held our latest national learning event on the neighbourhood care work being tested across the country.
With representation from Health and Social Care Partnerships and national organisations, the aim of the workshop was as much about exploring the challenges to developing this model of care as it was about sharing learning and increasing knowledge across Scotland.
After welcomes and introductions from Ruth Glassborow (Director of Improvement Support and ihub), Chris Bruce provided some background on how Scotland became involved in learning from the Buurtzorg model in the Netherlands, with an overview of the work so far.
All agencies and partners involved in developing local models – using the principles of Buurtzorg (and in the spirit of self-organisation) – have worked together to develop tests and start building a national learning community. Continue reading “Updates from the Neighbourhood Care national partners meeting”
Chief Officers and their representatives from the 31 Health & Social Care Partnerships were invited to take part in Intermediate Care & Reablement scoping, comprised of an online survey and conversation about Intermediate Care & Reablement within their partnership area.
As part of the outputs from the scoping, the following Atlas provides information on the provision of Intermediate Care & Reablement across Scotland. It anticipated that this will be a live document that can be updated to reflect developments over time.
Download the atlas here or click the image above.
We commissioned a series of films to introduce anticipatory care planning, how it can help to deliver person-centred care, and its benefits for people, families and their carers.
A homeless person’s story – Duncan is 41 and has been in children’s homes, hostels, psychiatric care or homeless for most of his life.
A child’s story – Jack has a life-limiting condition. His parents have been told it is unlikely he’ll get to school age.
A carer’s story – Fiona was caring for her husband with cancer until he died. Now she is caring for her father alone.
An individuals story – Jim is in his fifties and is in the late stages of kidney failure caused by diabetes. His condition is terminal.
An ACP nurse’s story – Evelyn was admitted to hospital for the fourth time and diagnosed with Menieres diease. She is focussed on her illness rather than her recovery.
Find out more about Anticipatory Care Planning at myacp.scot